As Medicare Advantage Dominates, What Comes Next?

As Congress focuses on budget reconciliation and debates over Medicaid dominate the headlines, another major shift in health coverage continues quietly but powerfully—the explosive growth of Medicare Advantage (MA). Now covering more than half of all Medicare beneficiaries, MA plans are transforming the health care landscape in ways that can no longer be ignored.In this episode, Chip Kahn sits down with Molly Turco, a former CMS senior policy advisor and health policy expert at her firm MTT Strategies, to dig into the rise of Medicare Advantage, the challenges it presents for hospitals and patients, and what commonsense policy is needed to ensure the program delivers on its promises.Key topics include: Medicare Advantage by the numbers particularly in rural markets;MA Plans bring added benefits for the consumer but at a cost, including financial warning signs and long-term sustainability;  Hospital and provider obstacles, including prior authorization, observation care, and claim denials; and, Bipartisan policy shifts focusing on transparency and plan practices.Guest Bio: Molly T. Turco is a Medicare policy expert with over 15 years of experience shaping national healthcare strategy. Molly has dedicated her career to helping healthcare work better for people. She recently launched MTT Strategies, where she provides strategic and policy consulting services with a focus on Medicare Advantage and Medicare Part D. She previously served as Senior Policy Advisor for Medicare Advantage and Part D at the Center for Medicare at the Centers for Medicare & Medicaid Services (CMS), where she helped lead major initiatives to improve transparency, payment accuracy, and consumer protections in Medicare Advantage and Part D — including reforms under the Inflation Reduction Act. Prior to her work at CMS, Molly led Medicare policy efforts at the Blue Cross Blue Shield Association and the Better Medicare Alliance. She also brings experience as an investor consultant and public health researcher. Molly holds a BA from Middlebury College and a Master of Public Health from the Dartmouth Institute for Health Policy & Clinical Practice. She lives in Washington, D.C., with frequent trips to her home state of Vermont.

Medicaid is making headlines on Capitol Hill, and the debate is about more than just crunching numbers—it’s about people. This joint federal-state Medicaid program is a lifeline for millions of Americans, including children, seniors, people with disabilities, veterans, and low-income adults. From primary care to nursing home services, Medicaid provides critical coverage and support. But today, policy proposals under consideration in Washington could put that care at risk. In this episode, host Chip Kahn is joined by Medicaid policy expert Matt Salo, founder and CEO of Salo Health Strategies and former founding executive director of the National Association of Medicaid Directors. Matt brings decades of experience navigating the intersection of Medicaid and the practical implications of policy changes. Together, Matt and Chip dive into the policy cuts on the table and examine what they mean for patients in communities across the country.Key topics include: Medicaid’s design as a complex but critical program;What’s on the table in Washington from per-capita caps to block grants; and,The “waste, fraud, and abuse” narrative and downstream effects. Guest Bio: Matt Salo is the founder and CEO of Salo Health Strategies, a boutique healthcare consulting firm in the Washington DC area that specializes in strategic advice, health care policy, Medicaid market development and relationship building across 56 states and US territories. The firm capitalizes on decades of experience working with state and federal government officials as well as the full spectrum of Medicaid and broader health care stakeholders ranging from health plans, providers, pharmaceutical companies, foundations, and consumer groups. Matt is the founding Executive Director of the National Association of Medicaid Directors (NAMD), having started the association in February 2011, and he worked in that role until he stepped down in August 2022. The organization represents the state government leaders responsible for administering the Medicaid program. NAMD was established as a permanent community for state leaders to share best practices, and worked to develop technical assistance, invest in leadership development, and formulate a strong unified voice in communication with Congress, the Administration, and other key national stakeholders. He built the organization from an initial staff of one to a full-time complement of ten staff and an operating budget of more than $3 million. Matt formerly spent 12 years at the National Governors Association, where he worked on the Governors’ health care and human services reform agendas. His major accomplishments included getting legislation passed that guaranteed state control of the entire $250 Billion tobacco Master Settlement Agreement, which resulted in Forbes Magazine naming NGA one of the nation’s top ten most influential lobbying organizations. He also worked to get legislative approval of more than $100 billion in state fiscal relief during the Great Recession; and in bringing bipartisan groups of Governors together on multiple occasions to reach agreement on Medicaid reform proposals, ultimately serving as the backbone for the Deficit Reduction Act of 2007. Matt was a substitute teacher for two years in the Alexandria City public school system before joining the DC health policy world. He holds a BA in Eastern Religious Studies from the University of Virginia, and is still trying to find ways to explain how that got him to where he is today. Matt is a nationally recognized expert in Medicaid, state government, health care reform, federalism, long term care. He was recently named by Washingtonian Magazine as one of the 500 most influential people in Washington DC. He is a member of the National Academy of Social Insurance (NASI), and was recently recognized by the National Academy of State Health Policy as its 2022 Academy Award Winner for a lifetime of contributions to health policy. 

“Hospitals in Focus” takes a high-level look at how Americans really feel about two  cornerstones of health coverage in our country: Medicaid and the enhanced premium tax  credits available through the individual marketplace. Joining Chip Kahn on this episode is Bob Ward, a partner at polling firm Fabrizio Ward,  whose team recently conducted two national surveys examining public opinion on these  programs. The findings might surprise you—voters from across the political spectrum,  including MAGA Republicans, swing voters, and Democrats, overwhelmingly support  Medicaid and premium tax credits, even as partisan debates on potential cuts and the  extension of the enhanced tax credits continue in Washington. Key topics include: • Understanding the demographics and makeup of voters; • How views on Medicaid and the enhanced tax credits break traditional party lines; • What the data reveals about coverage concerns; and, • How lawmakers can better align with what Americans actually want. References:  Medicaid Attitudes Poll Memo for Modern Medicaid Alliance BAF Economy & Tax Poll for Building America’s Future Guest Bio:  Bob Ward is a partner of Fabrizio Ward, a public affairs polling firm he co-founded with  Tony Fabrizio, lead pollster for President Donald Trump. Ward is a veteran political pollster,  having worked for Republican candidates at all levels of government. Internationally his  political work extends to elections and NGOs in Europe, Asia, and Africa. He provides  political polling and election insights for a range of advocacy groups.  Ward has over 30 years of public and stakeholder opinion research experience,  specializing in public affairs research, corporate image, reputation, and issues  management. His counsel and research have guided a wide range of client engagements  including public affairs campaigns designed to influence policy makers, product liability crises, high profile litigation, long-term reputation measurement and management, to  message development supporting everything from rebranding universities, launching  advocacy groups, and product roll-outs. 

Medicaid, together with the Children’s Health Insurance Program (CHIP), forms the backbone of pediatric care in the United States — providing nearly 40 million children with access to routine checkups to life-saving hospital services. But that care is at risk. Congress is considering cuts to Medicaid funding, which could have devastating consequences for kids and the specialized hospitals that serve them.In this episode, Chip Kahn is joined by Matthew Cook, President and CEO of the Children’s Hospital Association. With decades of leadership experience on the floors of children’s hospitals and now serving as a national advocate, Matt offers powerful stories into what’s at stake if Medicaid is scaled back — and why protecting it is critical for the health and future of America’s children.Key topics include:The scope of Medicaid’s support for children’s health;The role of children’s hospitals in providing pediatric care;Unique challenges facing children’s hospitals;What proposed Medicaid cuts could mean for access, treatment delays, and pediatric services; and,What lawmakers need to understand beyond balancing the budget.Guest Bio:  Matthew Cook is President and CEO of Children’s Hospital Association (CHA), representing over 200 children’s hospitals and health systems as the leading national advocates for children’s health.   Cook is an established health care industry executive with decades of unparalleled leadership which includes leadership roles at children’s hospitals and maternal health programs. Cook also previously served as a member of CHA’s Board of Trustees and Public Policy Committees.  Prior to joining CHA, Cook served as president of UCSF Benioff Children's Hospitals and senior vice president of Children’s Services at UCSF Health, where he oversaw strategic direction, operations, and clinical services for all pediatric services in both Oakland and San Francisco, as well as serving on the UCSF Health leadership team.   Cook previously served as president of Riley Children’s Health and chief strategy officer for Indiana University Health and served as executive vice president of strategic planning and business development at Children's Hospital of Philadelphia. Cook was also a principal at the Chartis Group, a health care consulting firm based in Chicago.  Cook earned a Master of Business Administration from New York University and graduated cum laude with a Bachelor of Science in Economics from The Wharton School of the University of Pennsylvania.   

Rural America is a vital part of our nation—rich in culture, community, and resilience. But potential Medicaid cuts coupled with the impending expiration of enhanced tax credits further threatens rural communities’ access to health care and puts the strength of rural communities at risk. In this episode, Chip Kahn is joined once again by Alan Morgan, CEO of the National Rural Health Association, to explore the impacts of Medicaid cuts and Americans’ loss of health coverage on rural hospitals and what is at stake for patient care if lawmakers fail to protect these institutions.Key topics include: The current state of rural health care and why it matters to all Americans;What hospital closures mean for rural patients;The policy levers that could make or break the future of rural hospitals; and,Why Medicaid and the enhanced tax credits are essential to access care.References: Washington Post “Republican Medicaid cuts could shutter rural hospitals, maternity care” (https://www.washingtonpost.com/health/2025/03/08/medicaid-cuts-rural-hospitals/)About: Alan Morgan joined NRHA staff in 2001 and currently serves as Chief Executive Officer of the association.  Recognized as among the top 100 most influential people in health care by Modern Healthcare Magazine, Alan Morgan serves as Chief Executive Officer for the National Rural Health Association. He has more than 30 years experience in health policy at the state and federal level, and is one of the nation’s leading experts on rural health policy.Mr. Morgan served as a contributing author for the publications, “Policy & Politics in Nursing and Health Care,” “The Handbook of Rural Aging” and for the publication, “Rural Populations and Health.” In addition, his health policy articles have been published in: The American Journal of Clinical Medicine, The Journal of Rural Health, The Journal of Cardiovascular Management, The Journal of Pacing and Clinical Electrophysiology, Cardiac Electrophysiology Review, and in Laboratory Medicine. Mr. Morgan served as staff for former US Congressman Dick Nichols and former Kansas Governor Mike Hayden. Additionally, his past experience includes tenures as a health care lobbyist for the American Society of Clinical Pathologists, the Heart Rhythm Society, and for VHA Inc.He holds a bachelor's degree in journalism from University of Kansas, and a master's degree in public administration from George Mason University.

Medicaid provides health coverage for more than 70 million Americans, including children, veterans, seniors, and people with disabilities. But as Congress works toward a reconciliation bill, proposed cuts totaling $880 billion have raised serious concerns about the program’s future and the impacts on patients and providers.In this episode, Chip Kahn sits down with Dr. Bruce Siegel, President and CEO of America’s Essential Hospitals, as he reflects on his 15 years of leadership, the critical role of serving uninsured and low-income patients, and the high stakes of the Medicaid debate unfolding in Washington.Key topics include:The evolving role of essential hospitals and the need to serve uninsured and low-income patients;Medicaid’s role in the health system and why it is essential for patient care;The real-world impact of Medicaid cuts, including consequences for nursing home stays, community-based services, and hospital operations;Debunking the misconception that having insurance doesn’t improve health outcomes; and,Bruce’s advice for future health care leaders and what’s next for him after America’s Essential Hospitals.Guest Bio: With an extensive background in health care management, policy, and public health, Bruce Siegel, MD, MPH, has the blend of experience necessary to lead America’s Essential Hospitals and its members through the changing health care landscape and into a sustainable future. With more than 350 members, America’s Essential Hospitals is the only national organization representing hospitals committed to serving those who face financial and social barriers to care. Since joining America’s Essential Hospitals in 2010, Siegel has dramatically grown the association as it strengthened its advocacy, research, and education efforts. His intimate knowledge of member needs comes in part from his direct experience as president and CEO of two member systems: New York City Health and Hospitals Corporation and Tampa General Healthcare. Just before joining America’s Essential Hospitals, Siegel served as director of the Center for Health Care Quality and professor of health policy at The George Washington University School of Public Health and Health Services. He also served as New Jersey’s commissioner of health. Among his many accomplishments, Siegel led groundbreaking work on quality and equity, with funding from the Robert Wood Johnson Foundation. He is a past chair of the National Quality Forum board and the National Advisory Council for Healthcare Research and Quality. Modern Healthcare recognized him as one of the “100 Most Influential People in Healthcare” from 2011 to 2019 and 2022 to 2024; among the “50 Most Influential Clinical Executives” in 2022, 2023, and 2024; among the “Top 25 Diversity Leaders in Healthcare” in 2021; one of the “50 Most Influential Physician Executives” from 2012 to 2018; and among the “Top 25 Minority Executives in Healthcare” in 2014 and 2016. He also was named one of the “50 Most Powerful People in Healthcare” by Becker’s Hospital Review in 2013 and 2014. Siegel earned a bachelor’s degree from Princeton University, a doctor of medicine from Cornell University Medical College, and a master’s degree in public health from The Johns Hopkins University School of Hygiene and Public Health.

Medicaid, the largest health insurance program in the country, provides critical coverage for more than 79 million Americans—including children, pregnant women, seniors, and people with disabilities. As Congress considers ways to achieve $2.5 trillion in deficit reduction, Medicaid is at risk of significant changes and proposals that could seriously harm patient care.In this episode, Chip Kahn sits down with Hemi Tewarson, Executive Director of the National Academy for State Health Policy, to discuss the potential impact of Medicaid cuts on patients, hospitals and providers, and state governments. Key topics include: The current state of Medicaid and its economic impact;What’s on the legislative agenda, including, proposed changes like work requirements, per capita caps, and shifts in state-directed payments; and,The role of data, policy decisions, and the future of Medicaid at the state level.Guest Bio: Hemi Tewarson, JD, MPH is the executive director of the National Academy for State Health Policy (NASHP), a nonprofit and nonpartisan organization committed to improving the health and well-being of all people across every state. At NASHP, Hemi leads an organization that is at the forefront of engaging state leaders and bringing together partners to develop and advance state health policy innovations. Under her direction, NASHP is leading efforts with states in areas including state COVID-19 recovery, health care costs and value, coverage, child and family health, aging, family caregiving, health care workforce, behavioral health, social determinants of health, health equity, and public health modernization. Previously, Hemi worked at the Duke-Margolis Center for Health Policy as a senior fellow and served as the director of the Health Division at the National Governors Association’s Center for Best Practices. She also served as senior attorney for the Office of the General Counsel at the U.S. Government Accountability Office addressing Medicaid and related health care topics for members of Congress.  She holds a JD from George Washington University, an MPH from George Washington University, and a BA in Psychology, University of Pennsylvania. She lives in Maryland with her husband and two daughters.

With a new Administration and a Republican-controlled Congress stepping into power, a wave of changes is sweeping across Washington. From immigration and military renewal to energy dominance and tax cuts, the agenda is ambitious. But what does this mean for health care policy, hospitals, and patient care?In this episode, Joel White, President and CEO of Horizon Government Affairs, unpacks the evolving health policy landscape. Together, Chip and Joel explore how federal priorities, budgetary concerns, and legislative goals are shaping health care’s future under a new administration.Key Topics Covered:What’s driving federal policymaking in the current landscape;The GOP agenda and health care priorities for the Administration including Make America Healthy Again and the Department of Government Efficiency;The art of the possible and the policies that stand a chance of crossing the finish line; and, Budget reconciliation, funding challenges, and potential impacts on Medicare and Medicaid.Guest Bio: Joel is the Founder and President of Horizon Government Affairs (HGA), a health care consultancy that represents two dozen clients and runs four coalitions comprised of 200 organizations dedicated to reforms that improve our health system. Since Horizon’s founding in 2007, his team has helped enact more than 50 laws and helped shape countless regulations governing all aspects of the U.S. health care system. Joel is also the President of the Council for Affordable Health Coverage, an HGA-managed coalition to improve affordability, increase competition in health care, and protect and strengthen employee health coverage. Recent campaigns include reforming the Inflation Reduction Act, promoting outcomes-based arrangements for gene therapies, and expanding small-group coverage. Previously, Joel spent twelve years on Capitol Hill including as Staff Director of the Ways and Means Health Subcommittee. While on the Hill he helped enact nine laws, including the 2002 Trade Act, which created health care tax credits for private coverage, the 2003 law that established the Medicare prescription drug benefit and Health Savings Accounts, the 2005 Deficit Reduction Act, and the 2006 Tax Reform and Health Care Act, which reformed Medicare payment policies. Joel is on the Boards of Directors of Samaritan Inns, Arlington Bridge Builders, the Schizophrenia and Psychosis Action Alliance, SafeNetRx, and Chaddock Behavioral Health. Joel holds a B.S. in Economics from the American University and is the co-author of the book, Facts and Figures on Government Finance.

In this episode of Hospitals in Focus, we revisit a vital topic—disaster preparedness and response. Hurricanes Helene and Milton caused devastating impacts across the Southeast, including catastrophic flooding in Asheville, North Carolina. FAH-member HCA Healthcare stepped up to the challenge, and their Mission Hospital became a beacon of resilience, treating over 500 emergency patients in the first hours after Hurricane Helene, flying in 400 nurses and 40 physicians from sister facilities, and ensuring the community had access to essential services.Michael Wargo, HCA Healthcare’s Vice President of Enterprise Preparedness & Emergency Operations, provides listeners with a 360-degree view of emergency preparedness. Mike shares lessons learned, the importance of planning for the “known unknowns,” and how HCA’s leadership prioritizes readiness at all levels. Chip and Mike also explore broader considerations for disaster recovery, from practical on-the-ground strategies to policy changes so hospitals can remain resilient in the face of future disasters.Key Topics Covered:HCA’s approach to readiness with the five “R’s” of emergency operations;Mission Hospital’s hurricane response;Leadership’s role in fostering a culture of preparedness; and,Recovery efforts and challenges taxpaying hospitals face, including the need for commonsense, bipartisan policies to support these critical institutions. Guest Bio: Mr. Michael Wargo serves as HCA Healthcare’s enterprise Vice President for Preparedness & Emergency Operations based in Nashville, TN. Mike joined HCA Healthcare in 2016 as the Assistant VP of Enterprise Emergency Operations, a role in which he was tasked to redesign and lead the organization’s disaster and emergency operations program in readiness, response, and recovery from adverse natural and man-made incidents across both the U.S. and the metro London area of the UK. Mike brings more than 25 years of clinical experience in high quality, patient centered care and nearly two decades in public safety leadership. Mike is the Executive Officer and immediate past Chair of the U.S. Health and Public Health Sector Coordination Council of the National Critical Infrastructure Protection Program sanctioned by Homeland Security Presidential Directive 21. In this role, he collaborates and serves as a trusted advisor to both federal secretary-level & SES leadership and senior private industry executives on readiness, response, and recovery initiatives impacting the U.S. national health security and critical infrastructure protection. Additionally, he served as the Chair of the Emergency Preparedness Committee for the Federation of American Hospitals. Mike is a veteran healthcare executive with experience leading the medical operations division of Northeast Regional Counter-Terrorism Task Force based in PA. He is the prior Administrator and Chief of Emergency Operations for Lehigh Valley Health Network, and an experienced flight nurse and Administrator of LVHN-MedEvac. Federally, Mike served in an intermittent position as a Supervisory Nurse Specialist for the U.S. Dept. of Health and Human Services National Disaster Medical Services. His combined experience includes both domestic and international homeland security and medical response training & operations. Mike holds multiple certifications in homeland security, disaster preparedness and is one of the first Certified Medical Transport Executives worldwide. He is a graduate of the American Military University with a Master of Business Administration degree, Kutztown University of PA with a Bachelor of Science Degree in Nursing and is a graduate of St. Luke’s School of Nursing with a Diploma of Nursing. Continuing his post-graduate studies, Mike is near completion of the Doctor of Public Health degree program at Indiana University Fairbanks School of Public Health.Mike was recently awarded with the “Director’s Award for Outstanding Service to Mission” by the U.S. Secret Service for his leading the Pandemic Health Security & Medical Operations of the final 2020 U.S. Presidential Debate.

Every year, millions of Americans face the life-changing news of a cancer diagnosis. Beyond the battle for survival and recovery, there is another critical fight—the battle to ensure patients and their families have access to affordable care.In this episode, we look at the intersection of health care policy and cancer care with Pam Traxel, Senior Vice President of the American Cancer Society Cancer Action Network (ACS CAN). ACS CAN champions cancer patients, survivors, and their loved ones by advocating for expanded access to health care, funding for cancer research, and policies that make lifesaving treatments more accessible.The Enhanced Premium Tax Credits (EPTCs) have proven to be critical tools, helping millions of Americans afford health insurance, including those grappling with the high costs of cancer treatment. With the threat of these credits expiring, the stakes for cancer patients and their loved ones couldn’t be higher. Pam breaks down the potential consequences of losing this critical lifeline and shares how ACS CAN is mobilizing to protect access to affordable health care for all.Key Topics Covered:Role of ACS CAN in fighting for cancer patients and families;Potential expiration of Enhanced Premium Tax Credits and its devastating implications;Importance of health insurance in cancer diagnosis and survival rates; and,Data showing how EPTCs improve patient outcomes and protect access to care.Studies mentioned in the episode: Health insurance status and cancer stage at diagnosis and survival in the United States: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21732How ACA Tax Credits Impact Patients With Chronic Conditions: https://www.oliverwyman.com/our-expertise/insights/2024/sep/premium-tax-credit-ending-chronic-conditions-at-risk.htmlCancer Patients & Survivors Overwhelmingly Support Extending ACA Enhanced Tax Credits:  https://www.fightcancer.org/policy-resources/cancer-patients-survivors-overwhelmingly-support-extending-aca-enhanced-tax-creditsGuest Bio: Pam Traxel serves as the Senior Vice President for ACS CAN, the advocacy affiliate of the America Cancer Society.  Pam is responsible for helping ACS CAN develop relationships with companies and individuals to help further the fight against cancer through dynamic partnerships, events, and forums.  Pam began her career with ACS CAN in 2007.  She has been integrally involved in helping to establish ACS CAN as a nationwide advocacy organization that influences and shapes public policy at all levels of government to impact our mission and to represent the voices of all cancer patients and their families.