Podcast: KHN’s ‘What The Health?’ VA Secretary Out, Privatization In?

David Shulkin, the secretary of Veterans Affairs, was fired Wednesday night by President Donald Trump. To replace him, Trump will nominate his White House physician, naval Rear Adm. Ronny Jackson. Shulkin, however, is not going quietly. He took to The New York Times op-ed page to claim he was pushed out by those who want to privatize VA health services for profit.

Meanwhile, two more states, Iowa and Utah, passed legislation that would sidestep some of the requirements of the Affordable Care Act. Iowa wants to allow the sale of health plans that cover fewer benefits — or restrict coverage for people with preexisting health conditions. Utah wants to expand Medicaid to those higher up the income scale — but not as high as prescribed by the ACA.

This week’s panelists for KHN’s “What the Health?” are Julie Rovner of Kaiser Health News, Anna Edney of Bloomberg News, Sarah Kliff of Vox.com and Alice Ollstein of Talking Points Memo.

Among the takeaways from this week’s podcast:

  • If Shulkin is right that the administration is keen on privatizing the VA, would it move to something akin to the Medicaid managed-care systems that many states have set up?
  • Veterans groups haven’t yet shown their cards on whether they think Jackson is a suitable choice to replace Shulkin.
  • Iowa is poised to allow farmers groups to offer health plans that could sidestep some of the consumer protections in the federal Affordable Care Act, such as requiring that preexisting conditions be covered. Tennessee has a program similar to what Iowa is implementing, and some consumer groups have complained it pulls healthy individuals out of the ACA marketplace and drives up premiums for those who remain.
  • Utah’s request for a federal waiver so that it can offer a Medicaid expansion program to people earning up to 100 percent of the federal poverty level — and not the 138 percent included in the ACA — will show whether the Trump administration has a different standard than the Obama administration. Obama officials rejected partial Medicaid expansion requests.
  • Sen. Elizabeth Warren (D-Mass.) introduced a bill that offers provisions to help middle-income customers buying insurance on the ACA marketplace. But it suggests Democrats are still not sure what is the best health care strategy heading into the midterm elections.

New Segment: ‘Bill Of The Month’

This month, Shefali Luthra talks about the case of the $1,500 tube of toenail fungus cream and how patients can never be too careful in asking how much a prescription will cost.

If you want to submit a bill for the “Bill of the Month” series, here is the form.

Several other news outlets are reaching out to patients to crowdsource some health stories. If you’re uninsured and you want to share your story with Bloomberg News, here’s where you can do that.

And if you have an emergency room bill you’d like to share for this Vox.com project, here’s the form.

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

Julie Rovner: Bloomberg News’ “Why Some Americans Are Risking It and Skipping Health Insurance,” by John Tozzi.

Anna Edney: Kaiser Health News’ “As Trump Targets Immigrants, Elderly Brace To Lose Caregivers,” by Melissa Bailey.

Alice Ollstein: The Brookings Institution and the University of Southern California’s “Do States Regret Expanding Medicaid?” by Mark Hall.

Sarah Kliff: Kaiser Health News’ “Reporter’s Notebook: The Tale Of Theranos And The Mysterious Fire Alarm,” by Jenny Gold.

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Cost and Quality Insurance Multimedia Pharmaceuticals States The Health Law