The State of the Affordable Care Act

November 1 marked the start of open enrollment for 2026 health plans bought from Affordable Care Act marketplaces in most states. But this sign-up season is like no other in the health law’s 15-year history. It remains unclear, even at this late date, whether expanded tax credits launched during the pandemic in 2021 will be continued or allowed to expire, exposing millions of Americans to much higher out-of-pocket costs. In this special episode of “What the Health?” from KFF Health News and WAMU, host Julie Rovner interviews KFF vice president Cynthia Cox about the past, present, and possible future of the health law and how those who purchase ACA coverage should proceed during this time of uncertainty. Visit our website to read a transcript of this episode.

A standoff in Congress is keeping much of the federal government shut down as open enrollment begins in most states for Affordable Care Act plans. Democrats have refused to vote on spending until Republicans agree to extend more generous ACA premium tax credits, but so far there has been little negotiating — even as customers are learning what they’ll pay for coverage next year. Meanwhile, the Trump administration is telling states they can’t pass their own laws to keep medical debt off consumers’ credit reports, after killing a Biden-era effort to end the practice nationwide. Paige Winfield Cunningham of The Washington Post, Alice Miranda Ollstein of Politico, and Maya Goldman of Axios join KFF Health News’ Julie Rovner to discuss those stories and more. Visit our website to read a transcript of this episode.Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: KFF Health News’ “Many Fear Federal Loan Caps Will Deter Aspiring Doctors and Worsen MD Shortage,” by Bernard J. Wolfson. Alice Miranda Ollstein: ProPublica’s “Citing Trump Order on ‘Biological Truth,’ VA Makes It Harder for Male Veterans With Breast Cancer To Get Coverage,” by Eric Umansky.  Paige Winfield Cunningham: The Washington Post’s “Study Finds mRNA Coronavirus Vaccines Prolonged Life of Cancer Patients,” by Mark Johnson.  Maya Goldman: KFF Health News’ “As Sports Betting Explodes, States Try To Set Limits To Stop Gambling Addiction,” by Karen Brown, New England Public Media.  

Two major nutrition programs — supporting low-income families, as well as young children and pregnant or breastfeeding women — are likely to exhaust their funding in November, and the furloughs and firings at the Centers for Disease Control and Prevention have left the agency unable to perform some of its major functions.Meanwhile, President Donald Trump’s new policy on in vitro fertilization is being met with dissatisfaction from both sides of the controversial issue.Rachel Roubein of The Washington Post, Alice Miranda Ollstein of Politico, and Shefali Luthra of The 19th join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews KFF Health News’ Katheryn Houghton, who wrote the latest “Bill of the Month” feature, about a broken elbow and a nearly six-figure bill.  Visit our website for a transcript of the episode.Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: ProPublica’s “The Shadow President,” by Andy Kroll. Shefali Luthra: The 19th’s “More People Are Freezing Their Eggs — But Most Will Never Use Them,” by Shalini Kathuria Narang, Rewire News Group.  Alice Miranda Ollstein: Brown University’s “New Study: AI Chatbots Systematically Violate Mental Health Ethics Standards.”  Rachel Roubein: The Washington Post’s “Errors in New Medicare Plan Portal Mislead Seniors on Coverage,” by Dan Diamond and Akilah Johnson.  

Two major nutrition programs — supporting low-income families, as well as young children and pregnant or breastfeeding women — are likely to exhaust their funding in November, and the furloughs and firings at the Centers for Disease Control and Prevention have left the agency unable to perform some of its major functions.Meanwhile, President Donald Trump’s new policy on in vitro fertilization is being met with dissatisfaction from both sides of the controversial issue.Rachel Roubein of The Washington Post, Alice Miranda Ollstein of Politico, and Shefali Luthra of The 19th join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews KFF Health News’ Katheryn Houghton, who wrote the latest “Bill of the Month” feature, about a broken elbow and a nearly six-figure bill.  Visit our website for a transcript of the episode.Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: ProPublica’s “The Shadow President,” by Andy Kroll. Shefali Luthra: The 19th’s “More People Are Freezing Their Eggs — But Most Will Never Use Them,” by Shalini Kathuria Narang, Rewire News Group.  Alice Miranda Ollstein: Brown University’s “New Study: AI Chatbots Systematically Violate Mental Health Ethics Standards.”  Rachel Roubein: The Washington Post’s “Errors in New Medicare Plan Portal Mislead Seniors on Coverage,” by Dan Diamond and Akilah Johnson.   Hosted on Acast. See acast.com/privacy for more information.

Democrats and Republicans remain stalled over funding the federal government as Republicans launch a new attack on the Affordable Care Act. Meanwhile, the Trump administration is taking advantage of the shutdown to lay off workers from programs supported mostly by Democrats. Anna Edney of Bloomberg News, Lauren Weber of The Washington Post, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews health insurance analyst Louise Norris about Medicare open enrollment, which began Oct. 15. Visit our website for a transcript of this episode.Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: Politico’s “RFK Jr.’s Got Advice for Pregnant Women. There’s Limited Data To Support It,” by Alice Miranda Ollstein.  Joanne Kenen: Mother Jones’ “From Medicine to Mysticism: The Radicalization of Florida’s Top Doc,” by Kiera Butler and Julianne McShane.  Lauren Weber: KFF Health News’ “Senators Press Deloitte, Other Contractors on Errors in Medicaid Eligibility Systems,” by Rachana Pradhan and Samantha Liss.  Anna Edney: The New York Times’ “The Drug That Took Away More Than Her Appetite,” by Maia Szalavitz.  

Democrats and Republicans remain stalled over funding the federal government as Republicans launch a new attack on the Affordable Care Act. Meanwhile, the Trump administration is taking advantage of the shutdown to lay off workers from programs supported mostly by Democrats.Anna Edney of Bloomberg News, Lauren Weber of The Washington Post, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine join KFF Health News’ Julie Rovner to discuss those stories and more.Also this week, Rovner interviews health insurance analyst Louise Norris about Medicare open enrollment, which began Oct. 15. Visit our website for a transcript of this episode.Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: Politico’s “RFK Jr.’s Got Advice for Pregnant Women. There’s Limited Data To Support It,” by Alice Miranda Ollstein.  Joanne Kenen: Mother Jones’ “From Medicine to Mysticism: The Radicalization of Florida’s Top Doc,” by Kiera Butler and Julianne McShane.  Lauren Weber: KFF Health News’ “Senators Press Deloitte, Other Contractors on Errors in Medicaid Eligibility Systems,” by Rachana Pradhan and Samantha Liss.  Anna Edney: The New York Times’ “The Drug That Took Away More Than Her Appetite,” by Maia Szalavitz.   Hosted on Acast. See acast.com/privacy for more information.

The government shutdown continues with no obvious end in sight, and while it theoretically should not affect entitlement programs like Medicare and Medicaid, the lapse of some related authorizations — like for Medicare telehealth programs — is leaving some doctors and patients high and dry. Meanwhile, the FDA quietly approved a new generic abortion pill, prompting a not-so-quiet reaction from anti-abortion groups. Alice Miranda Ollstein of Politico, Tami Luhby of CNN, and Sarah Karlin-Smith of Pink Sheet join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews Sarah Grusin of the National Health Law Program about the GOP’s misleading claims that Democrats shut down the government in pursuit of free health care for immigrants who are in the country illegally.   Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too:  Julie Rovner: The Washington Post’s “How Some Veterans Exploit $193 Billion VA Program, Due to Lax Controls,” by Craig Whitlock, Lisa Rein, and Caitlin Gilbert.  Tami Luhby: The Washington Post’s “Trump Plan Would Limit Disability Benefits for Older Americans,” by Meryl Kornfield and Lisa Rein.  Sarah Karlin-Smith: The New York Times’ “It’s Just a Virus, the E.R. Told Him. Days Later, He Was Dead,” by Lisa Miller.  Alice Miranda Ollstein: The 19th’s “Ice Fears Put Pregnant Immigrants and Their Babies at Risk” by Mel Leonor Barclay and Shefali Luthra. Hosted on Acast. See acast.com/privacy for more information.

As long predicted, much of the federal government shut down Oct. 1 after Congress failed to pass required spending bills, with Democrats demanding Republicans renew the expiring Affordable Care Act subsidies in exchange for votes. While a shutdown does not affect Medicare and Medicaid, it could eventually hinder activities from every corner of the Department of Health and Human Services.Meanwhile, as Democrats and Republicans point fingers, HHS Secretary Robert F. Kennedy Jr. pursues policies and personnel undermining vaccines.Lauren Weber of The Washington Post, Shefali Luthra of The 19th, and Rachel Cohrs Zhang of Bloomberg News join KFF Health News’ Julie Rovner to discuss the news.Also this week, Rovner interviews KFF Health News’ Cara Anthony, who wrote the latest “Bill of the Month” feature, about an out-of-network eye surgery that left one kindergartner’s family with a big bill. Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:  Julie Rovner: KFF Health News’ “Big Loopholes in Hospital Charity Care Programs Mean Patients Still Get Stuck With the Tab,” by Michelle Andrews.  Shefali Luthra: The Washington Post’s “Trump’s USAID Pause Stranded Lifesaving Drugs. Children Died Waiting,” by Meg Kelly, Joyce Sohyun Lee, Rael Ombuor, Sarah Blaskey, Andrew Ba Tran, Artur Galocha, Eric Lau, and Katharine Houreld.  Lauren Weber: Time Magazine’s “Trump Is Breaking Americans’ Trust in Doctors,” by Dr. Craig Spencer.  Rachel Cohrs Zhang: ProPublica’s “Georgia’s Medicaid Work Requirement Program Spent Twice as Much on Administrative Costs as on Health Care, GAO Says,” by Margaret Coker, The Current.  Visit our website to read a transcript of this episode. Hosted on Acast. See acast.com/privacy for more information.

In a rambling news conference that shocked public health experts, President Donald Trump this week — without scientific evidence — blamed the over-the-counter drug acetaminophen, and too many childhood vaccines, for the increase in autism diagnoses in the U.S. That came days after a key immunization advisory committee, newly reconstituted with vaccine doubters, changed several long-standing recommendations.Former Centers for Disease Control and Prevention official Demetre Daskalakis joins KFF Health News’ Julie Rovner to discuss those stories. Meanwhile, Sandhya Raman of CQ Roll Call and Anna Edney of Bloomberg News join Rovner with the rest of the news, including a threat by the Trump administration to fire rather than furlough federal workers if Congress fails to fund the government beyond the Oct. 1 start of the new fiscal year. Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too: Julie Rovner: NBC News’ “RFK Jr. Has the Federal Vaccine Court in His Sights. Attacking It Could Threaten Vaccine Production in the U.S.,” by Liz Szabo.  Anna Edney: The Washington Post’s “Do State Abortion Laws Affect Women’s Recruiting? That’s Up to Athletes,” by Kevin B. Blackistone.  Sandhya Raman: ProPublica’s “Psychiatric Hospitals Turn Away Patients Who Need Urgent Care. The Facilities Face Few Consequences,” by Eli Cahan.  Visit our website to read a transcript of this episode. Hosted on Acast. See acast.com/privacy for more information.

The recently fired head of the Centers for Disease Control and Prevention told senators that health secretary Robert F. Kennedy Jr. ordered her to fire top officials and agree to approve changes to national vaccine recommendations — before the recommendations were made and regardless of what the science says. Meanwhile, Congress heads toward a government shutdown, with expanded subsidies for Affordable Care Act plans in the balance.Alice Miranda Ollstein of Politico, Margot Sanger-Katz of The New York Times, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine join KFF Health News’ Julie Rovner to discuss the news.Also, Rovner interviews Troyen Brennan, former chief medical officer at Aetna and CVS, about his new book on primary care.Plus, for “extra credit,” the panelists suggest health policy stories they read (or wrote) this week that they think you should read, too:  Julie Rovner: The New York Times Magazine’s “Trump Is Shutting Down the War on Cancer,” by Jonathan Mahler.  Margot Sanger-Katz: ProPublica’s “Programs for Students With Hearing and Vision Loss Harmed by Trump’s Anti-Diversity Push,” by Jodi S. Cohen and Jennifer Smith Richards.  Alice Miranda Ollstein: The New York Times’ “I Have Dental Insurance. Why Do I Pay So Much for Care?” by Erica Sweeney.  Joanne Kenen: Politico Magazine’s “Why Voters Will Feel the Impact of GOP Health Cuts Before the Midterms,” by Joanne Kenen.  Visit our website to read a transcript of this episode. Hosted on Acast. See acast.com/privacy for more information.