KHN’s ‘What the Health?’: The Changing of the Guard

26/11/2022

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The coming Congress will look different from the current one: While Democrats narrowly kept control of the U.S. Senate, Republicans gained a majority in the House. While their majority is small, it will likely be enough to block any further items on President Joe Biden’s agenda.

Meanwhile, the current, lame-duck Congress still has a lot of items on its to-do list, including keeping the government open and averting a scheduled 4% cut in payments to health providers.

This week’s panelists are Julie Rovner of KHN, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Victoria Knight of Axios, and Alice Miranda Ollstein of Politico.

Among the takeaways from this week’s episode:

With Democrats holding the Senate, Sen. Bernie Sanders (I-Vt.) is expected to be the next chairman of the Committee of Health, Education, Labor, and Pensions. In that role he would be able to set a more progressive agenda, though he could not push changes to Medicare, which is not under the committee’s jurisdiction. Sen. Bill Cassidy (R-La.), a doctor who worked on surprise billing legislation, is in line to become HELP’s top Republican.
Republicans clinched control of the House of Representatives and have nominated Rep. Kevin McCarthy (R-Calif.) to be speaker, though he’ll have to overcome tensions over weaker-than-expected midterm results. While there are chances to demonstrate bipartisanship, like on telehealth regulation, the party will be able to push back against the Democratic-controlled Senate and White House. Watch for investigations into the Biden administration and Republican refusals to fund the government and raise the debt ceiling.
In the states, Oregon voters approved a constitutional amendment that establishes an individual right to health care, though it doesn’t give the state the ability to spend money to ensure that right. It remains to be seen what the change means, although it possibly opens the door for residents to sue the state over health care affordability.
A liberal group, the Fairness Project, was behind a wave of successful ballot measures last week, capitalizing on the gap between voters and Republican lawmakers on issues like abortion and Medicaid expansion. Both parties have found success in using ballot initiatives to draw voters to the polls during non-presidential election years, and this year Democratic election officials like Gov. Gretchen Whitmer of Michigan appear to have benefited from such measures.
Congress is staring down a busy lame-duck session, with must-dos including funding the government and averting long-scheduled cuts to Medicare payments. Pandemic preparedness and maternal health legislation are also on the list of possibilities. President Biden is still pushing for more money for covid-19 relief as existing pandemic funds run out, though Republicans are unlikely to budge in their opposition.
Codification of abortion rights looks unlikely for now. Neither party appears to have the support to pass national protections or national restrictions, though appropriations fights are expected over a few existing policies, including those affecting incarcerated women and Indigenous women. Meanwhile, the U.S. Conference of Catholic Bishops elected two hard-line opponents this week, and the courts are scrutinizing state bans in Georgia and Kentucky, as Florida talks about increasing restrictions there.
The Cleveland Clinic has instituted a policy of charging patients’ insurance $50 to answer any message sent to providers through its online portal that takes more than five minutes of their time to respond to. Insurance companies are likely to push back, but watch for the policy to spread to other providers.
A yearlong KHN project on private equity ownership in health care wrapped this week with reporting showing private equity has poured nearly $1 trillion into 8,000 health care transactions in just the past decade. But weak reporting requirements mean the federal government is often not reviewing these transactions for potential antitrust violations.

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

Julie Rovner: The Philadelphia Inquirer’s “,” by Sarah Gantz

Alice Miranda Ollstein: ProPublica’s “,” by Kavitha Surana

Victoria Knight: The Daily Beast’s “,” by Will Sommer

Joanne Kenen: The Pink Sheet’s “” by Sarah Karlin-Smith

Also mentioned in this week’s episode:

Axios’ “,” by Sabrina Moreno

Cleveland.com’s “,” by Julie Washington

KHN’s “” by Fred Schulte

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