The Health Wonk Shop

Feb 10 2025 19 ep. 47 mins 3

The Health Wonk Shop Podcast artwork

KFF presents conversations that dive into timely health policy issues with experts for a deeper discussion beyond the news headlines.
Hosted on Acast. See acast.com/privacy for more information.

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What’s Next for the Affordable Care Act?

Feb 10 2025 46 mins

Health coverage enrollment through the Affordable Care Act (ACA) marketplaces now exceeds 24 million people, a dramatic increase in recent years fueled largely by enhanced premium aid, which started in 2021 as part of the American Rescue Plan Act and extended through 2025 under the Inflation Reduction Act. But, with the subsidies set to expire at the end of this year, Congress and

What the 2024 Election Could Mean for Health Coverage, Affordability, and the Budget

Oct 01 2024 46 mins

As the 2024 presidential election draws near, there are sharp differences in former President Trump’s and Vice President Harris’ records on health coverage and spending, including the Affordable Care Act, Medicaid, prescription drugs, and more. Larry Levitt, KFF’s executive vice president for health policy, moderated a 45-minute discussion with two veteran health policy advis

Beyond Chevron: How the Court’s Decision Will Change Health Policy Legislating and Rulemaking

Jul 25 2024 53 mins

The Supreme Court’s June 28 decision overturning the Chevron precedent that required federal courts to defer to reasonable agency decisions when federal law is unclear creates potential challenges for crafting health policy legislation and regulations. On July 25, 2024, a panel of experienced policy and legal experts explored how Congress and federal health agencies are

What’s Behind the Buzz about Site-Neutral Payments?

Jun 17 2024 41 mins

With Congress looking for ways to cut health care costs for patients and the Medicare program, one approach drawing bipartisan attention involves site-neutral payments for outpatient services. The idea is for Medicare to pay the same amount for a service regardless of where it is provided – a departure from current Medicare reimbursement policy, which generally pays higher rates

Primary Care Check Up: Why It Can Be Hard to Get an Appointment and How to Fix It

Apr 03 2024 50 mins

A panel of primary-care experts joined Larry Levitt, KFF’s executive vice president for health policy, for a discussion on the current state of primary care in the country, including the extent of the shortage, how it varies geographically and for different populations, the impact on people’s health, and what can be done to address it. Hosted on Acast. See acast.com/privacy for

Prior Authorization in Health Insurance: A Needed Tool to Contain Costs or an Excessive Barrier to Needed Care?

Feb 22 2024 48 mins

Nearly 1 in 5 consumers with health insurance say their insurer delayed or denied care in the past year due to its requirements for prior authorization, a process through which insurers can require patients to obtain approval in advance before they will agree to cover specific services.Insurers point to prior authorization as a tool to limit unnecessary and ineffective care, thereb

The Health Care Workforce Under Pressure: Strikes, Shortages, and Staffing Requirements

Nov 16 2023 48 mins

Amid low unemployment and rising demand for services, today’s health care workforce is under pressure from several directions, including worker strikes; shortages of trained staff; and proposed new staffing standards for nurses and aides in nursing facilities.On November 16, a panel of three experts joined Larry Levitt, executive vice president for health policy at KFF, for a 45-

Probing the Legal Arguments in the Drug Industry’s Challenges to Medicare Drug Price Negotiations

Oct 12 2023 44 mins

With the Biden administration’s announcement of the first 10 drugs to be negotiated for Medicare as part of the Inflation Reduction Act (IRA), an array of legal challenges from the pharmaceutical industry is potentially the biggest obstacle to implementation.In court filings, individual drugmakers and the industry’s main lobbying group contend that the negotiations process is u

New Weight Loss Drugs Raise Issues of Coverage, Cost, Access and Equity

Aug 17 2023 45 mins

New weight loss drugs, such as Novo Nordisk’s Ozempic and Wegovy (semaglutide) and Eli Lilly’s Mounjaro (tirzepatide), could be transformative for people who struggle with obesity and obesity-related medical conditions, but there are major questions to consider related to insurance coverage, the cost of the drugs, and who has access.Importantly, by law, the drugs cannot be cove

Probing the Power and Practices of Pharmacy Benefit Managers

Jun 22 2023 44 mins

Pharmacy benefit managers (PBMs) are increasingly scrutinized intermediaries in the U.S. health care system, negotiating discounts on prescription medications for health insurers and employers while collecting rebates from drugmakers.Even as PBMs have taken on a larger role in drug coverage and pricing in recent decades, including through mergers with insurers, the business arrange