{"id":2177532,"date":"2026-04-02T15:00:00","date_gmt":"2026-04-02T19:00:00","guid":{"rendered":"https:\/\/kffhealthnews.org\/?p=2177532&#038;post_type=podcast&#038;preview_id=2177532"},"modified":"2026-04-09T13:58:26","modified_gmt":"2026-04-09T17:58:26","slug":"what-the-health-440-gop-health-cuts-iran-april-2-2026","status":"publish","type":"podcast","link":"https:\/\/kffhealthnews.org\/news\/podcast\/what-the-health-440-gop-health-cuts-iran-april-2-2026\/","title":{"rendered":"What the Health? From KFF Health News: GOP Mulls More Health Cuts"},"content":{"rendered":"\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\"><div class=\"block--iframe\">\n\t<iframe\n\t\tallow=\"fullscreen\"\n\t\tframeborder=\"0\"\n\t\theight=\"188\"\n\t\tsrc=\"https:\/\/play.prx.org\/e?ge=prx_14448_10abf5b4-a828-42b5-a529-7af0e226bb03&#038;uf=https%3A%2F%2Fwhatthehealth.feeds.wamu.org\"\n\t\twidth=\"100%\"\n\t><\/iframe>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people block--people\">\n\t\t<h3 class=\"people-title\">\n\t\tThe Host\t<\/h3>\n\t\t<div class=\"people-card-container single\">\n\t\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg 1100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Julie Rovner<\/div>\n\t<div class=\"author-affiliation\">KFF Health News<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/jrovner\" title=\"@jrovner\">\n\t\t\t\t@jrovner\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/julierovner.bsky.social\" title=\"@julierovner.bsky.social\">\n\t\t\t\t@julierovner.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"https:\/\/kffhealthnews.org\/news\/author\/julie-rovner\/\"> \n\t\t\t\tRead Julie&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News\u2019 weekly health policy news podcast, &quot;What the Health?&quot; A noted expert on health policy issues, Julie is the author of the critically praised reference book &quot;Health Care Politics and Policy A to Z,&quot; now in its third edition.\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n\n<p>Recent polling finds that health costs are a top worry for much of the American public, while Republicans in Congress are considering still more cuts to federal health spending on programs such as Medicaid and the Affordable Care Act.<\/p>\n\n\n\n<p>Meanwhile, the Supreme Court ruled that Colorado cannot ban mental health professionals from using \u201cconversion therapy\u201d to treat LGBTQ+ minors, a decision that\u2019s likely to affect other states with similar laws.<\/p>\n\n\n\n<p>This week\u2019s panelists are Julie Rovner of KFF Health News, Jessie Hellmann of CQ Roll Call, Alice Miranda Ollstein of Politico, and Sandhya Raman of Bloomberg Law.<\/p>\n\n\n\n<div class=\"wp-block-people block--people\">\n\t\t<h3 class=\"people-title\">\n\t\tPanelists\t<\/h3>\n\t\t<div class=\"people-card-container threewide\">\n\t\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg 800w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/03\/Hellmann_800sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Jessie Hellmann<\/div>\n\t<div class=\"author-affiliation\">CQ Roll Call<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/jessiehellmann\" title=\"@jessiehellmann\">\n\t\t\t\t@jessiehellmann\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/jessiehellmann.bsky.social\" title=\"@jessiehellmann.bsky.social\">\n\t\t\t\t@jessiehellmann.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"https:\/\/rollcall.com\/author\/jessie-hellmann\/\"> \n\t\t\t\tRead Jessie&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg 800w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Alice Miranda Ollstein<\/div>\n\t<div class=\"author-affiliation\">Politico<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/AliceOllstein\" title=\"@AliceOllstein\">\n\t\t\t\t@AliceOllstein\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/alicemiranda.bsky.social\" title=\"@alicemiranda.bsky.social\">\n\t\t\t\t@alicemiranda.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"https:\/\/www.politico.com\/staff\/alice-miranda-ollstein\"> \n\t\t\t\tRead Alice&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png 683w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Raman_683sq.png?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Sandhya Raman<\/div>\n\t<div class=\"author-affiliation\">Bloomberg Law<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/SandhyaWrites\" title=\"@SandhyaWrites\">\n\t\t\t\t@SandhyaWrites\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/sandhyawrites.bsky.social\" title=\"@sandhyawrites.bsky.social\">\n\t\t\t\t@sandhyawrites.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n\n<p>Among the takeaways from this week\u2019s episode:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Republicans reportedly are weighing still more cuts to federal health spending. With the war in Iran draining military coffers, GOP leaders in Congress are eying a drop in health funding \u2014 a decision that could exacerbate problems following the passage of legislation expected to lead to major reductions in Medicaid spending, as well as the expiration of enhanced ACA premium subsidies that were not renewed by lawmakers last year. And President Donald Trump\u2019s budget could include another sizable reduction in funding to the National Institutes of Health.<\/li>\n\n\n\n<li>The Supreme Court this week struck down a Colorado law prohibiting licensed professionals from practicing a form of therapy that tries to change the sexual orientation or gender identity of LGBTQ+ minors. States have long had the power to regulate medical care, with the goal of restricting treatments that can be harmful. Also, the Idaho Legislature passed a bill requiring teachers and doctors to out transgender minors to their parents.<\/li>\n\n\n\n<li>Meanwhile, the Department of Health and Human Services is studying whether to make private Medicare Advantage plans the default option for seniors enrolling in Medicare, a change that would seem to conflict with the Trump administration\u2019s scrutiny of overpayments to the private insurance plans. And a tech nonprofit\u2019s lawsuit seeks to reveal more about the administration\u2019s pilot program testing the use of artificial intelligence in prior authorization in Medicare.<\/li>\n<\/ul>\n\n\n\n<p>Also this week, Rovner interviews KFF Health News\u2019 Elisabeth Rosenthal, who wrote the <a href=\"https:\/\/kffhealthnews.org\/news\/article\/expensive-drug-copay-card-discount-bill-of-the-month-february-2026\/\">last<\/a> <a href=\"https:\/\/kffhealthnews.org\/news\/article\/insurer-missed-payments-dropped-coverage-florida-bill-of-the-month-march-2026\/\">two<\/a> KFF Health News \u201cBill of the Month\u201d stories. If you have a medical bill that\u2019s outrageous, infuriating, or just inscrutable, <a href=\"https:\/\/kffhealthnews.org\/send-us-your-medical-bills\/\">you can submit it to us here<\/a>.<\/p>\n\n\n<div\n\tclass=\"wp-block block--newsletter  \"\n\tdata-type=\"kaiser-health-news\/newsletter\"\n\tdata-align=\"center\"\n\tstyle=\"\"\n>\n\t<h4 class=\"newsletter__title\">\n\t\t<a href=\"\/email\/\">\n\t\t\tEmail Sign-Up\t\t<\/a>\n\t<\/h4>\n\t<p class=\"newsletter__description\">\n\t\tSubscribe to KFF Health News&#039; free Morning Briefing.\t<\/p>\n\t\n<form\n\taction=\"\/email-signup\/\"\n\tclass=\"kaiser-hubspot-mini-signup-form\"\n\tmethod=\"post\"\n>\n\t<input type=\"hidden\" id=\"kaiser_hubspot_nonce\" name=\"kaiser_hubspot_nonce\" value=\"87a489a56a\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/podcast\/2177532\" \/>\t\t\t\t<label\n\t\tclass=\"kaiser-hubspot-mini-signup-form__label--email\"\n\t\tfor=\"kaiser-hubspot-mini-signup-form-email\"\n\t>\n\t\t<span class=\"screen-reader-text\">\n\t\t\tYour Email Address\t\t<\/span>\n\t\t<input\n\t\t\tautocomplete=\"email\"\n\t\t\tclass=\"kaiser-hubspot-mini-signup-form__input--email\"\n\t\t\tid=\"kaiser-hubspot-mini-signup-form-email\"\n\t\t\tname=\"kaiser_hubspot_email\"\n\t\t\ttype=\"email\"\n\t\t\t\t\t\t\tplaceholder=\"Your email address\"\n\t\t\t\t\t\/>\n\t<\/label>\n\t<button class=\"kaiser-hubspot-mini-signup-form__submit\">\n\t\tSign Up\t<\/button>\n<\/form>\n<\/div>\n\n\n\n<p>Plus, for \u201cextra credit,\u201d the panelists suggest health policy stories they read this week that they think you should read, too:\u00a0<\/p>\n\n\n\n<p><strong>Julie Rovner:<\/strong> New York Magazine\u2019s \u201c<a href=\"https:\/\/nymag.com\/intelligencer\/article\/pet-medical-tourism-tijuana-mexico-california-veterinarian.html\">The Dog Owners Taking Their Injured Corgis and Doodles to Tijuana: Mexico Is to Pet MRIs What Turkey Has Become for Hair Transplants<\/a>,\u201d by Helaine Olen.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Jessie Hellmann:<\/strong> The Texas Tribune\u2019s \u201c<a href=\"https:\/\/www.texastribune.org\/2026\/03\/30\/texas-undocumented-immigrants-health-care-hospitals\/\">\u2018Don\u2019t&nbsp;Take Me to the Hospital\u2019: Undocumented Immigrants in Texas Are Delaying Medical Care<\/a>,\u201d by Colleen DeGuzman, Stephen Simpson, Terri Langford, and Dan Keemahill.&nbsp;<\/p>\n\n\n\n<p><strong>Sandhya Raman:<\/strong> Science\u2019s \u201c<a href=\"https:\/\/www.science.org\/content\/article\/supporters-push-revive-moribund-agency-studying-patient-care\">Supporters Push To Revive Moribund Agency Studying Patient Care<\/a>,\u201d by Jocelyn Kaiser.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Alice Miranda Ollstein:<\/strong> The New York Times\u2019 \u201c<a href=\"https:\/\/www.nytimes.com\/2026\/03\/26\/world\/americas\/cubas-health-system-us-oil-blockade.html\">Cuban Patients Are Dying Because of U.S. Blockade, Doctors Say<\/a>,\u201d by Ed Augustin and Jack Nicas.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Also mentioned in this week\u2019s podcast:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>KFF Health News\u2019 \u201c<a href=\"https:\/\/kffhealthnews.org\/news\/article\/state-medicaid-work-requirements-eligibility-systems-deloitte-accenture-optum\/\">States Pay Deloitte, Others Millions To Comply With Trump Law To Cut Medicaid Rolls<\/a>,\u201d by Samantha Liss and Rachana Pradhan.<\/li>\n\n\n\n<li>KFF Health News\u2019 \u201c<a href=\"https:\/\/kffhealthnews.org\/news\/article\/medicaid-undocumented-enrollees-review-few-violators\/\">Trump\u2019s Hunt for Undocumented Medicaid Enrollees Yields Few Violators<\/a>,\u201d by Phil Galewitz.<\/li>\n\n\n\n<li>The Colorado Sun\u2019s \u201c<a href=\"https:\/\/coloradosun.com\/2026\/03\/30\/childrens-hospital-colorado-gender-affirming-care-lawsuit\/\">Why Children\u2019s Hospital Colorado Has Not Resumed Gender-Affirming Care Despite a Favorable Court Ruling<\/a>,\u201d by John Ingold.<\/li>\n\n\n\n<li>Politico\u2019s \u201c<a href=\"https:\/\/www.politico.com\/news\/2026\/03\/30\/poll-maha-trump-kennedy-democrats-midterms-00846760\">Poll: The Battle for MAHA That Could Sway the Midterms<\/a>,\u201d by Alice Miranda Ollstein, Erin Doherty, Marcia Brown, and Carmen Paun.<\/li>\n\n\n\n<li>The New York Times Magazine\u2019s \u201c<a href=\"https:\/\/www.nytimes.com\/interactive\/2026\/03\/27\/magazine\/kennedy-maha-youth-wellness-influencer.html\">Why Some Teenage Girls Are Trading Medicine for MAHA<\/a>,\u201d by Coralie Kraft.<\/li>\n\n\n\n<li>NOTUS\u2019 \u201c<a href=\"https:\/\/www.notus.org\/health-science\/rfk-maha-medical-establishment-divided-on\">To Sue or To Woo? The Medical Establishment Is Divided on MAHA<\/a>,\u201d by Margaret Manto.<\/li>\n\n\n\n<li>The Dallas Morning News\u2019 \u201c<a href=\"https:\/\/www.dallasnews.com\/business\/health-care\/2026\/03\/27\/a-crisis-pregnancy-center-told-a-texas-woman-that-her-pregnancy-was-normal-it-wasnt\/\">A Texas Pregnancy Center Told Her Everything Was Fine. Three Days Later, She Aas in the ER<\/a>,\u201d by Emily Brindley.<\/li>\n<\/ul>\n\n\n\n<section class=\"block--expandable has-label\"\n\t\t\tid=\"podcast-expandable\"\n\t>\n\t\t\t<input type=\"checkbox\" name=\"expandable-radio\" id=\"transcript-gop-mulls-more-health-cuts\">\n\t\t<label class=\"expandable__title-label\" for=\"transcript-gop-mulls-more-health-cuts\">\n\t\t\t\t\t\t\t<span\n\t\t\t\t\tclass=\"expandable__label  \"\n\t\t\t\t\tstyle=\"background-color: #cb1919;\"\n\t\t\t\t>\n\t\t\t\t\tClick to open the transcript\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span\n\t\t\t\t\tclass=\"expandable__title\"\n\t\t\t\t\tstyle=\"font-size: 36px;\"\n\t\t\t\t>\n\t\t\t\t\t\tTranscript: GOP Mulls More Health Cuts\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\t\t<div class=\"expandable__content--container\">\n\t\t<div class=\"expandable__content\">\n\t\t\t\n\n<p><strong><em>[Editor\u2019s note:<\/em><\/strong><em>&nbsp;This transcript was generated using both transcription software and a human\u2019s light touch. It has been edited for style and clarity.]<\/em>&nbsp;<\/p>\n\n\n\n<p><strong>Julie Rovner:<\/strong>&nbsp;Hello, from KFF Health News and WAMU Public Radio in Washington, D.C. Welcome to&nbsp;<em>What the Health?<\/em>&nbsp;I\u2019m&nbsp;Julie Rovner, chief Washington correspondent for KFF Health News, and&nbsp;I\u2019m&nbsp;joined by some of the best and smartest&nbsp;health&nbsp;reporters covering Washington.&nbsp;We\u2019re&nbsp;taping this week on Thursday,&nbsp;April 2, at 10&nbsp;a.m.&nbsp;As always, news happens fast, and things might have changed by the time you hear this. So here we go.&nbsp;<\/p>\n\n\n\n<p>Today, we are joined&nbsp;via&nbsp;video conference by Alice Miranda&nbsp;Ollstein&nbsp;of Politico.&nbsp;<\/p>\n\n\n\n<p><strong>Alice Miranda&nbsp;Ollstein:<\/strong>&nbsp;Hello.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Jessie Hellmann&nbsp;of CQ&nbsp;Roll Call.&nbsp;<\/p>\n\n\n\n<p><strong>Jessie Hellmann:<\/strong>&nbsp;Thanks for having me.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And Sandhya&nbsp;Raman,&nbsp;now at Bloomberg Law.&nbsp;<\/p>\n\n\n\n<p><strong>Sandhya Raman:<\/strong>&nbsp;Hello, everyone.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Later in this episode,&nbsp;we\u2019ll&nbsp;have my interview with&nbsp;KFF Health News\u2019&nbsp;Elisabeth Rosenthal, who reported and wrote the last&nbsp;<em>two<\/em>&nbsp;KFF Health News&nbsp;\u201cBills of the&nbsp;Month.\u201d&nbsp;One is about a patient who got caught in the crossfire over prices between insurers and drug companies. The other is about a woman who, and this is not an April Fools\u2019&nbsp;joke, got her insurance canceled for&nbsp;failing to pay&nbsp;a bill for&nbsp;1&nbsp;cent. But first,&nbsp;this week\u2019s news.&nbsp;<\/p>\n\n\n\n<p>So&nbsp;Congress is on spring break, but when they come back,&nbsp;health&nbsp;policy will be waiting. A new Gallup poll out this week found 61% of those surveyed said they worry about the availability and affordability of health care, quote,&nbsp;\u201ca great deal.\u201d&nbsp;That was 10 percentage points more than the economy,&nbsp;inflation,&nbsp;and the federal budget deficit, and it topped a list of 15 domestic concerns. And while we are still waiting for final enrollment numbers for Affordable Care Act plans, we do know that the share of people paying more than $500 a month for their coverage doubled from last year to 2026.&nbsp;Yet Axios this week is reporting that Republicans are considering still more cuts to the Affordable Care Act to potentially pay for a&nbsp;$200 billion&nbsp;war supplemental. What exactly are they thinking? And&nbsp;it\u2019s&nbsp;looking more like Republicans are going to try for another budget reconciliation bill this spring. Isn\u2019t that, right,&nbsp;Jessie?&nbsp;<\/p>\n\n\n\n<p><strong>Hellmann:<\/strong>&nbsp;House&nbsp;Budget&nbsp;chair Jodey Arrington has kind of been pushing this idea&nbsp;really hard&nbsp;of going after what he says is fraud&nbsp;in&nbsp;mandatory programs like Medicare and Medicaid.&nbsp;He\u2019s&nbsp;also talked about funding&nbsp;cost-sharing&nbsp;reductions, which is an idea that slipped out of the last reconciliation bill, and&nbsp;it\u2019s&nbsp;a wonky kind of idea&nbsp;\u2026&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;But&nbsp;I think the best way to explain&nbsp;it&nbsp;is that it will raise premiums for many people.&nbsp;That\u2019s&nbsp;how&nbsp;I\u2019ve&nbsp;just been doing it.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Hellmann:<\/strong>&nbsp;Yeah, exactly.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Let\u2019s&nbsp;not get into the details.&nbsp;<\/p>\n\n\n\n<p><strong>Hellmann:&nbsp;<\/strong>It would&nbsp;reduce spending for the federal government but&nbsp;wouldn\u2019t&nbsp;really help people who buy insurance&nbsp;on&nbsp;the marketplace. He&nbsp;hasn\u2019t&nbsp;been&nbsp;very specific.&nbsp;He\u2019s&nbsp;also talked about,&nbsp;like,&nbsp;site-neutral&nbsp;policies&nbsp;in&nbsp;Medicare, but&nbsp;it\u2019s&nbsp;hard to see how all of this could make a serious&nbsp;dent in&nbsp;a&nbsp;$200 billion&nbsp;Iran supplemental.&nbsp;There\u2019s&nbsp;also a new development.&nbsp;I think President&nbsp;[Donald]&nbsp;Trump threw a wrench in things yesterday when he said he wanted the reconciliation bill to focus on border spending and immigration spending to cover a three-year period, and now Senate Majority Leader John Thune is saying that there\u2019s probably not room for much else in the bill. So,&nbsp;unclear what the path forward is for all of that.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah, and of course, that was part of the deal to free up the Department of Homeland Security\u2019s budget in the appropriation.&nbsp;It\u2019s&nbsp;all one sort of big, tied-up mess at this point.&nbsp;Alice, I see&nbsp;you\u2019re&nbsp;nodding.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>Yeah.&nbsp;I mean, what often happens with these reconciliation bills is it starts out with a tight focus and everyone\u2019s unified, and then, because it can often be the only legislative train leaving the station,&nbsp;everybody gets desperate to get their pet issue on board, and then the more and more things get piled onto it, then they start losing votes, and people start disagreeing more. And&nbsp;so&nbsp;I think even though this is still in the ideas phase,&nbsp;you\u2019re&nbsp;already seeing some signs of that happening. And when it comes to health care, it can be particularly fraught. And of course, you have lawmakers, especially in the&nbsp;House, with wildly&nbsp;different needs. Some of them need to fend off a primary from the right, and so they want to be as conservative as possible. Some are fighting to hang on in swing districts, and so they want to be more moderate. And these things are in conflict. And&nbsp;so&nbsp;these proposals to cut health spending, even more than the massive amount that was cut last year,&nbsp;are already, you know, raising some red flags among some moderate Republican members.&nbsp;And&nbsp;it\u2019s&nbsp;very possible the whole thing falls apart.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Well, along those lines,&nbsp;we\u2019re&nbsp;supposed to get the&nbsp;president\u2019s budget on Friday, which is only two months late. It was due in February.&nbsp;And while I&nbsp;haven\u2019t&nbsp;seen much on it, Jessie, your colleagues at&nbsp;Roll&nbsp;Call&nbsp;are reporting that the budget will seek a 20% cut to the National Institutes of Health.&nbsp;That\u2019s&nbsp;only half the cut that the administration proposed last year. But given that Congress actually boosted the&nbsp;agency\u2019s&nbsp;budget slightly this year, that feels kind of unlikely.&nbsp;<\/p>\n\n\n\n<p><strong>Hellmann:&nbsp;<\/strong>Yeah, I&nbsp;don\u2019t&nbsp;think that the appropriators are likely to&nbsp;go along with this.&nbsp;They have really strong advocates, and Sen.&nbsp;Susan Collins, who\u2019s chair of the Senate Appropriations Committee.&nbsp;And,&nbsp;like&nbsp;you&nbsp;said, they rejected cuts last year.&nbsp;Kind of surprised.&nbsp;Twenty percent&nbsp;is not as deep as the Trump administration went last year.&nbsp;I was actually kind of surprised it wasn\u2019t&nbsp;a&nbsp;bigger proposed cut.&nbsp;But either way, I&nbsp;don\u2019t&nbsp;think Congress is going to go along with that.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Meanwhile, I saw&nbsp;a late headline that FDA is looking to hire back people after&nbsp;DOGE [Department of Government Efficiency]&nbsp;cut&nbsp;thousands&nbsp;of people last year. Sandhya,&nbsp;HHS&nbsp;[Department of Health and Human Services]&nbsp;is just in this sort of personnel churn at this point, isn\u2019t it?&nbsp;<\/p>\n\n\n\n<p><strong>Raman:<\/strong>&nbsp;Yeah, I think that HHS is kind of getting&nbsp;bit&nbsp;in the foot from, you know, we\u2019ve had so many of these layoffs, and we\u2019ve also had a lot of people just flee the various agencies over the past year because of some of this instability and all of these changes. And as&nbsp;we\u2019re&nbsp;getting&nbsp;closer and closer&nbsp;to, you know, deadlines of things that they need to get done,&nbsp;they\u2019re&nbsp;realizing that they do need more personnel to get some of those things done,&nbsp;as&nbsp;we\u2019ve&nbsp;been passing deadlines.&nbsp;So&nbsp;I&nbsp;don\u2019t&nbsp;think&nbsp;it\u2019s&nbsp;something&nbsp;that\u2019s&nbsp;unique to just FDA.&nbsp;But I think the way to solve this&nbsp;\u2014&nbsp;it\u2019s&nbsp;not an overnight thing for the federal government to staff up.&nbsp;It\u2019s&nbsp;a longer process, but&nbsp;it\u2019s&nbsp;really showing in a lot of areas right now.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah, I would say this is not like TSA&nbsp;[Transportation Security&nbsp;Administration], where you can, you know, hire new&nbsp;people&nbsp;and train them up in a couple of months. These are&nbsp;\u2026&nbsp;many of them scientists&nbsp;who\u2019ve&nbsp;got years and years of training and experience at doing some of these jobs that,&nbsp;you know,&nbsp;the federal government is ordered to do by legislation.&nbsp;<\/p>\n\n\n\n<p><strong>Raman:<\/strong>&nbsp;Yeah, those&nbsp;statutes are things that,&nbsp;you know, if they&nbsp;don\u2019t&nbsp;meet those&nbsp;deadlines,&nbsp;those&nbsp;are things that are&nbsp;going to be challenged, and just further tie things up in litigation.&nbsp;And we already see so many of those right now that are making things more complicated.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Well, in news that is not from Congress or the administration, the Supreme Court this week said Colorado could not ban licensed mental health professionals from using so-called&nbsp;conversion therapy aimed at LGBTQ individuals, at least not on minors.&nbsp;What\u2019s&nbsp;the practical impact here? It goes well beyond Colorado,&nbsp;I&nbsp;would think.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>Interesting,&nbsp;because a lot of people think of this as regulating health care, restricting providers from providing health care that is not helpful and&nbsp;maybe actively&nbsp;harmful to the health of the patients.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And that\u2019s&nbsp;\u2026&nbsp;I would say&nbsp;that\u2019s&nbsp;been a state&nbsp;\u2026&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>Power.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;\u2026 power.&nbsp;For generations.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>Absolutely.&nbsp;Right,&nbsp;I mean, you don\u2019t want people selling sketchy snake oil pills on the street, etc. So many people view this as akin to that.&nbsp;But it has morphed in the hands of conservative courts into a free speech issue, and that, you know, these laws are restricting the speech of mental health workers who are against people transitioning. And so, yes, it&nbsp;definitely has&nbsp;national implications. And of course, we are in a national wave right now of both state and federal entities, you know, moving in the direction of rolling back trans rights in the health care space and beyond.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah. In related news,&nbsp;regarding&nbsp;Colorado and minors and gender,&nbsp;<a href=\"https:\/\/coloradosun.com\/2026\/03\/30\/childrens-hospital-colorado-gender-affirming-care-lawsuit\/\" target=\"_blank\" rel=\"noreferrer noopener\">The Colorado Sun reports<\/a>&nbsp;that Children\u2019s Hospital Colorado has not yet resumed providing gender-affirming care for transgender youth.&nbsp;That\u2019s&nbsp;despite a federal judge in Oregon having struck down an HHS declaration that would have punished hospitals for providing such services.&nbsp;Apparently, the&nbsp;hospital in Colorado is concerned that the&nbsp;judge\u2019s&nbsp;ruling&nbsp;doesn\u2019t&nbsp;provide it with enough legal cover for them to resume that care.&nbsp;I\u2019m&nbsp;wondering, is this the administration\u2019s strategy here to get organizations to do what they want, even if they might lack the legal authority to do it?&nbsp;Just by making them worry that they might come after them?&nbsp;<\/p>\n\n\n\n<p><strong>Raman<\/strong>:&nbsp;I think the chilling effect is definitely a big part of this broader issue.&nbsp;I mean, we\u2019ve seen it in other issues in the past, but just that if there is this worry that it\u2019s a)&nbsp;going to stop on the provider side, new folks taking part in providing care, and also just it\u2019s going to make patients, even if there are opportunities,&nbsp;even less likely to want to go because of the fears there. I mean, it goes broader than that.&nbsp;We\u2019ve&nbsp;had FTC&nbsp;[Federal Trade Commission]&nbsp;complaints,&nbsp;where they have gone and investigated&nbsp;different places&nbsp;that provide gender-affirming care or endorse it.&nbsp;So&nbsp;I think&nbsp;it\u2019s&nbsp;broader than this, and really part of that chilling effect.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And Alice, as you were saying, I mean, the subject of transgender rights, or lack thereof,&nbsp;remains&nbsp;a political hot topic. The Idaho&nbsp;Legislature this week passed a bill that now goes to the governor that would require teachers and doctors to out transgender minors to their parents. Parents could sue teachers, doctors,&nbsp;and&nbsp;child care&nbsp;providers who, quote,&nbsp;\u201cfacilitate the social transformation of the minor student.\u201d&nbsp;That includes using pronouns or titles that&nbsp;don\u2019t&nbsp;align with their sex at birth.&nbsp;I don\u2019t know about teachers, but that definitely seems to violate patient privacy when it comes to&nbsp;doctors, right?&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>There\u2019s definitely patient privacy issues there. I also think, you know,&nbsp;it\u2019s&nbsp;interesting that&nbsp;this kind of nonmedical&nbsp;transitioning&nbsp;is now coming under attack. Because, you know, you would think that there would be some support for letting a kid, you know, go by a different name for a few weeks, test it out, see how it feels.&nbsp;Maybe it\u2019s a phase, then they discover that they don\u2019t want to actually pursue taking medications and going through a medical transition.&nbsp;But this is sort of shutting down that avenue as well.&nbsp;You&nbsp;can\u2019t&nbsp;even change your appearance, change how you present in the world, at a time when kids are really trying to figure out who they are.&nbsp;So&nbsp;I think the broad acceptance of hostility to medical transitioning for youth is now spilling over into this kind of social transitioning, and I wonder if&nbsp;we\u2019re&nbsp;going to see more of that in the future.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah, I feel like we started with&nbsp;<em>minors&nbsp;shouldn\u2019t&nbsp;have surgery<\/em>.&nbsp;<em>They&nbsp;shouldn\u2019t&nbsp;do anything&nbsp;that\u2019s&nbsp;not easily reversible.&nbsp;<\/em>And now&nbsp;we\u2019ve&nbsp;gotten down to,&nbsp;in&nbsp;the Idaho&nbsp;law,&nbsp;there\u2019s&nbsp;actually mention&nbsp;of nicknames. You&nbsp;can\u2019t&nbsp;\u2026 a&nbsp;kid&nbsp;can\u2019t&nbsp;change his or her nickname. It feels like we\u2019ve&nbsp;sort of&nbsp;reduced&nbsp;this way, way, way down.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>And I think&nbsp;we\u2019ve&nbsp;seen these&nbsp;laws,&nbsp;laws related to bathrooms.&nbsp;We\u2019ve&nbsp;seen these have negative impacts on people who are not trans at all, people who just are a tomboy or not looking like people\u2019s stereotypes of what different genders may look like. And&nbsp;so&nbsp;there\u2019s&nbsp;a lot of policing of people who are not trans in any way. You know, there\u2019s media reports of people being confronted by law enforcement for going into a bathroom that does align with their biological sex. And&nbsp;so&nbsp;it\u2019s&nbsp;important to keep in mind that these laws have an effect&nbsp;that\u2019s&nbsp;much broader than just the&nbsp;very small&nbsp;percentage of people who do consider themselves trans.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah,&nbsp;it\u2019s&nbsp;kind of the&nbsp;opposite of not being&nbsp;woke. All&nbsp;right,&nbsp;we\u2019re&nbsp;going to take a quick break. We will be right back.&nbsp;&nbsp;<\/p>\n\n\n\n<p>So&nbsp;while&nbsp;we\u2019ve&nbsp;had lots of news out of the Department of Health and Human Services the past few weeks,&nbsp;it\u2019s&nbsp;been mostly public&nbsp;health-related.&nbsp;But&nbsp;there\u2019s&nbsp;a lot going on in the Medicare and Medicaid programs too. Item&nbsp;A:&nbsp;Stat News&nbsp;is reporting&nbsp;that HHS is studying whether to make the private Medicare Advantage program the default for seniors when they qualify for Medicare. Right now, you get the traditional fee-for-service plan that allows you to go to any doctor or hospital that accepts Medicare, which is most of them.&nbsp;You have to affirmatively opt into Medicare Advantage, which often provides extra benefits but also much narrower networks.&nbsp;What would it mean to make Medicare Advantage the default,&nbsp;that people would go into private plans instead of the&nbsp;government&nbsp;plan, unless they affirmatively opted for the traditional fee-for-service?&nbsp;<\/p>\n\n\n\n<p><strong>Hellmann:&nbsp;<\/strong>Someone\u2019s experience with&nbsp;\u2026&nbsp;can vary&nbsp;greatly between&nbsp;being on traditional Medicare and Medicare Advantage. If&nbsp;you\u2019re&nbsp;in Medicare Advantage, you could be exposed to narrow networks. You can only see certain doctors that are covered by your plan. You can be exposed to higher cost sharing. A lot of people are&nbsp;kind of fine&nbsp;with their plans until they have a medical issue and need to go to the hospital or they need skilled nursing care.&nbsp;So&nbsp;making this the default could definitely be a challenge for some people, especially people that have complex health needs. Some people on the early side of their Medicare eligibility are fine with Medicare Advantage, and then they get&nbsp;older&nbsp;and&nbsp;they\u2019re&nbsp;not fine with it anymore.&nbsp;So&nbsp;it\u2019s&nbsp;interesting that the administration would&nbsp;kind of float&nbsp;this&nbsp;idea&nbsp;because&nbsp;they\u2019ve&nbsp;been critical&nbsp;of Medicare Advantage.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Thank you.&nbsp;That\u2019s&nbsp;exactly what I was thinking.&nbsp;<\/p>\n\n\n\n<p><strong>Hellmann:&nbsp;<\/strong>Yeah,&nbsp;they\u2019ve&nbsp;talked about the federal government&nbsp;pays&nbsp;these plans too much, and&nbsp;it\u2019s&nbsp;not for better quality in a lot of cases, and&nbsp;they\u2019ve&nbsp;talked about reforms in that area.&nbsp;So&nbsp;I was a little&nbsp;surprised to see that.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah, Republicans have been super ambivalent. I mean, Medicare Advantage was their creation. They overpaid them at the beginning when they, you know,&nbsp;sort of redid&nbsp;the program in 2003.&nbsp;And they purposely overpaid them to get people into Medicare Advantage. And then the Democrats pointed out that this is wasting money because&nbsp;we\u2019re&nbsp;overpaying them. And now the Republicans seem to have joined a lot of their&nbsp;\u2014&nbsp;at least some Republicans&nbsp;\u2014&nbsp;seem to have joined a lot of the Democrats in saying,&nbsp;<em>Yes,&nbsp;we\u2019re&nbsp;overpaying them.&nbsp;We\u2019re&nbsp;paying&nbsp;them too much<\/em>. And you know, they talk about the big, powerful insurance companies, and yet&nbsp;they\u2019re&nbsp;now&nbsp;floating&nbsp;this idea to make Medicare Advantage the default.&nbsp;So&nbsp;pick a side, guys.&nbsp;<\/p>\n\n\n\n<p>All right, well, in other Medicare news, the Electronic Frontier Foundation is suing Medicare officials to learn more about the pilot program&nbsp;that\u2019s&nbsp;using artificial intelligence to oversee prior authorization requests in the traditional Medicare&nbsp;fee-for-service&nbsp;program.&nbsp;The idea here is to cut down on,&nbsp;quote,&nbsp;\u201clow-value services,\u201d&nbsp;things that doctors might be prescribing that aren\u2019t either particularly necessary or shown to actually work.&nbsp;But the fear, of course, is that needed care for patients will be delayed or denied, which is what&nbsp;we\u2019ve&nbsp;seen with prior authorization in Medicare Advantage. This is the perennial push-pull of our health care system, right? If you do everything that doctors say,&nbsp;it\u2019s&nbsp;going to be too expensive, and if you second-guess them,&nbsp;it\u2019s&nbsp;going to be,&nbsp;you know, it&nbsp;might turn out to be too constraining.&nbsp;<\/p>\n\n\n\n<p><strong>Hellmann:&nbsp;<\/strong>Well, I was just going to say&nbsp;this&nbsp;is another issue that was&nbsp;kind of a&nbsp;little surprising to me, because&nbsp;there\u2019s&nbsp;been so much criticism of the use of prior authorization and Medicare Advantage. And CMS&nbsp;[Centers for Medicare &amp; Medicaid Services]&nbsp;looked at that and said,&nbsp;<em>Oh, what if we did it in traditional Medicare?<\/em>&nbsp;Like it was never going to go over well politically,&nbsp;and&nbsp;I think there&nbsp;are even some Republican members of Congress who are not in support of this, but they&nbsp;haven\u2019t&nbsp;really made a huge stink about it.&nbsp;Yeah, this&nbsp;wasn\u2019t&nbsp;something I really expected&nbsp;to see.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah,&nbsp;we\u2019ll&nbsp;see how&nbsp;this one plays&nbsp;out too.&nbsp;Well, meanwhile,&nbsp;regarding&nbsp;Medicaid, two&nbsp;really good&nbsp;stories this week from my&nbsp;KFF Health News colleagues Phil&nbsp;Galewitz, Rachana Pradhan,&nbsp;and Samantha Liss.&nbsp;<a href=\"https:\/\/kffhealthnews.org\/news\/article\/medicaid-undocumented-enrollees-review-few-violators\/\" target=\"_blank\" rel=\"noreferrer noopener\">Phil\u2019s story<\/a>&nbsp;found that efforts in multiple states to find enrollees who were not eligible for the program due to their immigration status turned up very few violators. While&nbsp;<a href=\"https:\/\/kffhealthnews.org\/news\/article\/state-medicaid-work-requirements-eligibility-systems-deloitte-accenture-optum\/\" target=\"_blank\" rel=\"noreferrer noopener\">Samantha and&nbsp;Rachana&nbsp;detailed<\/a>&nbsp;the hundreds of millions of dollars states and the federal government are spending to set up computer programs to track&nbsp;Medicaid\u2019s new work requirement, despite the fact that we already know that most people on Medicaid either already work or they are exempt from the requirements under the new law. Is it just me, or are we spending lots of time and effort on&nbsp;both of these&nbsp;policies that are going to&nbsp;have not&nbsp;a very big&nbsp;return?&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>Well,&nbsp;that\u2019s&nbsp;what&nbsp;we\u2019ve&nbsp;seen in the few states that have gone ahead and&nbsp;attempted&nbsp;this before,&nbsp;that it costs a lot, and you insure fewer people. And&nbsp;that\u2019s&nbsp;not because those people got great jobs with great health&nbsp;care. You insure fewer people, and the level of employment does not meaningfully change.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>I would&nbsp;say you insure fewer people who may well still be eligible. They just get caught in the bureaucratic red tape of all&nbsp;of this.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>Exactly.&nbsp;These tech systems that are being set up are challenging to navigate, if people even have a means to do it, if they even have a smartphone or a computer or access to Wi-Fi.&nbsp;There are not that many physical offices they can&nbsp;go&nbsp;to&nbsp;to&nbsp;work it out if they need to. And some of those are&nbsp;very far&nbsp;from where they live. And&nbsp;so&nbsp;you see some of these tech vendors,&nbsp;you know, are set to make off very well out of this system, and people who need the care not so much. And then, of course, you know,&nbsp;it\u2019s&nbsp;not just the patients who will feel the impact. You have these hospitals around the country that are on the brink of closure. And if they have people who used to be insured&nbsp;\u2014&nbsp;they used to be able to bill and get reimbursed for their services, suddenly they\u2019re uninsured&nbsp;\u2014&nbsp;and they\u2019re coming in for emergency care that they can\u2019t pay for, that the hospital has to throw out-of-pocket for, that puts the strain that some of these facilities can barely cope with.&nbsp;And&nbsp;so&nbsp;you\u2019re&nbsp;seeing a lot of state hospital associations&nbsp;sounding&nbsp;the alarm as well.&nbsp;<\/p>\n\n\n\n<p><strong>Raman:&nbsp;<\/strong>I would also say the timing is interesting. You know, we spent so much time and energy last year going through the reconciliation process to tighten these areas, to get in the work requirements, to reduce immigrant eligibility for Medicaid. And then, you know, as they\u2019re gearing up to possibly do this again, to defer their crackdown on health care as part of that, instead of it saving money&nbsp;\u2014&nbsp;that it\u2019s not having as much of an effect and costing so much, in the case of the work requirements, where we\u2019re not expected to see the return of it.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Yeah, that may be, although&nbsp;I guess the return&nbsp;is that people will not have insurance anymore, and so the federal government,&nbsp;the states,&nbsp;won\u2019t&nbsp;be spending money&nbsp;for&nbsp;their medical care.&nbsp;They\u2019ll&nbsp;be spending money on other things. All right, of course,&nbsp;there\u2019s&nbsp;more news from HHS than just Medicare and Medicaid&nbsp;this week.&nbsp;We also have a lot of news about the Make America&nbsp;Healthy&nbsp;Again movement, which is a sentence&nbsp;that 2023&nbsp;me&nbsp;would&nbsp;definitely not&nbsp;recognize.&nbsp;<a href=\"https:\/\/www.politico.com\/news\/2026\/03\/30\/poll-maha-trump-kennedy-democrats-midterms-00846760\" target=\"_blank\" rel=\"noreferrer noopener\">Alice, you have a cool story this week<\/a>&nbsp;about a new poll that finds the MAHA vote&nbsp;isn\u2019t&nbsp;necessarily locked in with Republicans. Tell us about it.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>Yeah,&nbsp;that\u2019s&nbsp;right.&nbsp;So&nbsp;Politico did our own polling on this, because we&nbsp;hadn\u2019t&nbsp;really seen good data out there on who identifies as MAHA&nbsp;and what do they even believe about the different parties and about different issues. And&nbsp;so&nbsp;we found that,&nbsp;OK, yes, most people associate MAHA&nbsp;with the Republican Party&nbsp;\u2014&nbsp;most, but not all. But a lot of voters who identify as MAHA, and a lot of voters who voted for Trump in 2024&nbsp;don\u2019t&nbsp;think that the Trump administration has done&nbsp;a good job&nbsp;making America healthy again.&nbsp;And they rank the Democratic Party above the Republican Party on a lot of their top priority issues, like standing up to influence from the food industry and the pharmaceutical industry. They rank Democrats as caring more about health. So, you know, we found this very fascinating, and it supports what we\u2019ve been hearing anecdotally, where Democratic candidates, a handful of them, and&nbsp;Democratic electoral groups, are really seeing a lot of opportunity to go after MAHA&nbsp;voters and win them over for this November. And you know, we should remember that even if you&nbsp;don\u2019t&nbsp;see&nbsp;a big swing of people&nbsp;voting for Democrats, even if MAHA&nbsp;voters are disillusioned and stay home, that alone could decide races. You know, midterms are decided by very narrow margins.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Well, two other really interesting MAHA&nbsp;takes this week.&nbsp;<a href=\"https:\/\/www.notus.org\/health-science\/rfk-maha-medical-establishment-divided-on\" target=\"_blank\" rel=\"noreferrer noopener\">One is from&nbsp;NOTUS<\/a>.&nbsp;It\u2019s&nbsp;about the tension in and among medical groups, about how to deal with HHS Secretary&nbsp;[Robert&nbsp;F.]&nbsp;Kennedy&nbsp;[Jr.]&nbsp;and the MAHA movement. The American Medical Association seems to be trying to play nice, at least on things it agrees with the&nbsp;secretary about, lest it risk things like its giant contract to supply the CPT billing codes to Medicare. On the other hand, the American Academy of Pediatrics and the American College of Physicians have been more confrontational to the point of going to court.&nbsp;The other story,&nbsp;from&nbsp;<a href=\"https:\/\/www.nytimes.com\/interactive\/2026\/03\/27\/magazine\/kennedy-maha-youth-wellness-influencer.html\" target=\"_blank\" rel=\"noreferrer noopener\">The New York Times Magazine,&nbsp;profiles teen girl influencers<\/a>&nbsp;pushing MAHA.&nbsp;One thing I noticed is that&nbsp;all of&nbsp;the teens in the story seem to suffer from physical problems that are not well understood by the mainstream medical community, and so they turned online to seek advice instead, which is understandable in each individual case. But then they turn around and try to influence others. And you can see how easily misinformation can spread. It makes me not so much wonder&nbsp;\u2014&nbsp;it makes me see how, oh, this is how this stuff sort of gets out there, because you see so much&nbsp;\u2026 and Alice, this&nbsp;goes back to what you were saying about MAHA&nbsp;is not a movement that\u2019s allied with one particular political party.&nbsp;It\u2019s&nbsp;more of sort&nbsp;of a mindset that&nbsp;doesn\u2019t&nbsp;trust&nbsp;expertise.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>I think it&nbsp;spans people who identify as Democrats, identify as Republicans. And, you know,&nbsp;we\u2019re&nbsp;not really interested in politics until the rise of Robert F Kennedy Jr., and so I think it does show a lot of malleability. And there is a fight for this, for this cohort right now, on the airwaves, on the internet, etc.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And,&nbsp;as&nbsp;The New York Times pointed out, you know,&nbsp;we\u2019ve&nbsp;thought of this as being&nbsp;sort of a&nbsp;young men cohort.&nbsp;It\u2019s&nbsp;now also a young woman cohort,&nbsp;too.&nbsp;So&nbsp;there\u2019s&nbsp;lots of people out there to&nbsp;go and get,&nbsp;for these people who are pursuing votes.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Well, turning to reproductive health, we have a couple of follow-ups to things we covered earlier. The big one is&nbsp;Title&nbsp;X, the federal family planning program, whose grants were set to end as of April 1. Sandhya, it looks like the federal government is going to fund the program after all?&nbsp;<\/p>\n\n\n\n<p><strong>Raman:<\/strong>&nbsp;Yeah, the family planning grantees in this space have been on edge for so long, you know, waiting to see would they finally just issue the grant applications.&nbsp;And then it was such a short timeline for them to get them done. And then everyone that I talked to in the&nbsp;lead-up&nbsp;was expecting some sort of delay, just because it was such a short&nbsp;timeframe&nbsp;before they were set to run out of money. And&nbsp;so&nbsp;I think that they&nbsp;were all pleasantly surprised that HHS was able to turn things around when they confirmed that the money&nbsp;is&nbsp;going to go out the day before the deadline. It does take a couple&nbsp;of&nbsp;days to go through the process and get that done. But I think the new worry now is also that in the statements that the White House and HHS have made is just that they are still at work on getting&nbsp;Title&nbsp;X&nbsp;rulemaking out so that a lot of these groups would be ineligible if they also&nbsp;provide&nbsp;abortions.&nbsp;Or we also&nbsp;don\u2019t&nbsp;know what will be in the rule&nbsp;\u2014&nbsp;if it will be broader than what was under the last&nbsp;Trump administration, if it encompasses other restrictions.&nbsp;So&nbsp;a little bit of both there.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Yeah. And I also was&nbsp;gonna&nbsp;say, I mean, we know that anti-abortion groups are unhappy with the administration, so this would be one place where they could&nbsp;presumably throw&nbsp;them a bone, yes?&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>So&nbsp;people on both sides have been a little mystified why we&nbsp;haven\u2019t&nbsp;seen a new&nbsp;Title&nbsp;X&nbsp;rule yet.&nbsp;They were expecting that near the beginning of last year, especially if the administration was just planning to reimpose his 2019 version, that would be pretty straightforward and simple.&nbsp;And yet, here we are, more than a year into the administration, and we&nbsp;haven\u2019t&nbsp;really seen this yet. The administration did confirm to me&nbsp;\u2014&nbsp;we put this in our newsletter&nbsp;\u2014&nbsp;that a new rule is coming.&nbsp;And they said it will&nbsp;align with pro-life values. And the White House\u2019s comments to some conservative media outlets were very explicit that this will be the last time Planned Parenthood can get funding. Now I wonder if that statement will come back to bite them in court, because the rule previously was&nbsp;very careful&nbsp;not to name Planned Parenthood or name any specific organization. It just imposed criteria that applied to a lot of Planned Parenthood facilities, and&nbsp;in order to&nbsp;make them ineligible for&nbsp;Title&nbsp;X&nbsp;funding. And&nbsp;so&nbsp;I wonder if that will help Planned Parenthood&nbsp;sue&nbsp;later on.&nbsp;But&nbsp;we\u2019ll&nbsp;put a pin in that and come back to it.&nbsp;But we have confirmed that some sort of new rule is coming, but we don\u2019t know when, and we don\u2019t know what it would entail.&nbsp;There\u2019s&nbsp;a lot of speculation that this could go way beyond an attempt to kick Planned Parenthood out. There\u2019s speculation it could involve restrictions on&nbsp;particular forms&nbsp;of birth control. There\u2019s speculation that it could entail restrictions on gender-affirming care. There\u2019s speculation that it could involve rules around parental consent, stricter parental consent requirements, which are currently something that\u2019s not part of&nbsp;Title&nbsp;X. And&nbsp;so&nbsp;we just&nbsp;don\u2019t&nbsp;know, you know,&nbsp;in order to&nbsp;mollify the anti-abortion groups that are upset, they are saying,&nbsp;<em>Don\u2019t&nbsp;worry, new rule is coming<\/em>.&nbsp;But again, we don\u2019t know when, and we don\u2019t know what\u2019s going to be in it.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Well,&nbsp;we\u2019ll&nbsp;be here when it happens. Another topic&nbsp;we\u2019ve&nbsp;talked about at some length is crisis pregnancy centers, which are anti-abortion organizations that sometimes offer some medical services.&nbsp;<a href=\"https:\/\/www.dallasnews.com\/business\/health-care\/2026\/03\/27\/a-crisis-pregnancy-center-told-a-texas-woman-that-her-pregnancy-was-normal-it-wasnt\/\" target=\"_blank\" rel=\"noreferrer noopener\">This week, we learned about a Texas woman<\/a>&nbsp;who was told after an ultrasound at a crisis pregnancy center that she had a normal pregnancy, and three days later, ended up in emergency surgery because the pregnancy was not normal, but rather ectopic&nbsp;\u2014&nbsp;in other words, implanted in her fallopian tube rather than her uterus, which could have been fatal if not caught. This is not the first such case, but it again raises this question of whether these centers should be treated as medical facilities, which&nbsp;we\u2019ve&nbsp;talked about many states&nbsp;do.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Raman:<\/strong>&nbsp;And I think a lot of the rationale that people have for trying to do some of these&nbsp;mandatory ultrasounds, you know, encouraging people to go to this is because the talking point is that&nbsp;you don\u2019t know if you have an ectopic pregnancy, you don\u2019t have another complication, so you should go here to instead of just taking a medication abortion. So&nbsp;\u2026&nbsp;we\u2019re&nbsp;coming full circle here, where this is also not helping the&nbsp;case, if&nbsp;you\u2019re&nbsp;not finding the full information there.&nbsp;So&nbsp;I think that&nbsp;was an interesting point to me&nbsp;\u2026&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Yeah,&nbsp;it\u2019s&nbsp;going on both&nbsp;sides&nbsp;basically.&nbsp;It is fraught, and we will continue to cover it.&nbsp;<\/p>\n\n\n\n<p>All right, that is this week\u2019s news. Now&nbsp;we\u2019ll&nbsp;play my interview with Elisabeth Rosenthal at&nbsp;KFF Health News, and then we will come back and do&nbsp;our&nbsp;extra credits.&nbsp;<\/p>\n\n\n\n<p>I am pleased to welcome back to the podcast&nbsp;KFF Health News\u2019&nbsp;Elisabeth Rosenthal, who reported and wrote the last&nbsp;<em>two<\/em>&nbsp;\u201cBills of the&nbsp;Month.\u201d&nbsp;Libby, thanks for coming back.&nbsp;<\/p>\n\n\n\n<p><strong>Elisabeth Rosenthal:<\/strong>&nbsp;Thanks for having me.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;So&nbsp;let\u2019s&nbsp;start with our drug copay card patient.&nbsp;Before we get into the particulars,&nbsp;what\u2019s&nbsp;a&nbsp;drug copay card?&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>Well, copay cards, or&nbsp;copayment programs, are things that the drug companies give patients. You know,&nbsp;when it says you could pay as little as $0,&nbsp;where they&nbsp;pay&nbsp;your copayment, which is usually&nbsp;pretty big&nbsp;\u2014&nbsp;when you see a copay card, it means&nbsp;the&nbsp;price is big, and&nbsp;they\u2019ll&nbsp;bill your insurance for the rest.&nbsp;So&nbsp;for patients, it sounds like a good deal, and it is a good deal when they work.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>So&nbsp;tell us about this patient, and what drug did he need that cost so much that he&nbsp;required&nbsp;a copay card?&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>Well, the funny thing is&nbsp;\u2014&nbsp;his name is Jayant Mishra, and he has&nbsp;a psoriatic&nbsp;arthritis. And the doctor told him, you know,&nbsp;<em>there\u2019s&nbsp;this drug called Otezla that would really help you<\/em>.&nbsp;And he was, he was a little cautious, because he knew it could be expensive, so he did wait a few months, and his symptoms, his joint pain, in particular, got worse.&nbsp;He was like,&nbsp;<em>OK,&nbsp;I\u2019ll&nbsp;start it<\/em>.&nbsp;So&nbsp;he started it the first month, and it worked&nbsp;really well.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>\u201cIt\u201d&nbsp;the drug, or&nbsp;\u201cit\u201d&nbsp;the copay card, or both?&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>Both seemed to work very well.&nbsp;So&nbsp;the copay card covered his copay of over $5,000 and he was like,&nbsp;<em>Oh, this is great<\/em>. And then what happened was, the next month, he tried to fill&nbsp;it,&nbsp;and it was like,&nbsp;<em>Wait, the copay card&nbsp;didn\u2019t&nbsp;work<\/em>!&nbsp;And really what happens is copay&nbsp;cards,&nbsp;they are often limited in time and in the amount of money that\u2019s on them.&nbsp;So&nbsp;depending on how much the copay is,&nbsp;they can run out,&nbsp;basically expire. You used all the money, and you have a drug that&nbsp;you\u2019ve&nbsp;used that is working&nbsp;really well&nbsp;for you, and then suddenly&nbsp;you\u2019re&nbsp;hit with a big bill.&nbsp;So&nbsp;they&nbsp;kind of get&nbsp;people addicted to drugs,&nbsp;which they then&nbsp;can\u2019t&nbsp;afford.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And what happened&nbsp;in this case was the insurance company charged more than expected, right?&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>Well, Otezla, you know,&nbsp;there\u2019s&nbsp;so many things about this, and many&nbsp;\u201cBill of the&nbsp;Month\u201d&nbsp;stories that,&nbsp;you know,&nbsp;are eye-rollers. Otezla&nbsp;\u2014&nbsp;there are biosimilars that were approved by the FDA in&nbsp;\u2026&nbsp;2021?&nbsp;\u2026&nbsp;which&nbsp;everyone\u2019s&nbsp;talking about, faster approval of biosimilars. Well, this was approved, but the drugmaker filed multiple suits and patent infringement, and so in the U.S., it&nbsp;won\u2019t&nbsp;be on the market, the&nbsp;biosimilar,&nbsp;until 2028,&nbsp;so&nbsp;that\u2019s&nbsp;a problem too.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>So&nbsp;if you want this drug,&nbsp;it\u2019s&nbsp;going to be expensive.&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>It\u2019s&nbsp;going to be expensive. And the other problem is copay cards. Insurers used to say,&nbsp;OK, that will count towards your deductible, right?&nbsp;So&nbsp;you&nbsp;didn\u2019t&nbsp;really feel it,&nbsp;right?&nbsp;Because you got a $5,000 copay card,&nbsp;and you had a $5,000 deductible if you had a high-deductible plan.&nbsp;And everything was good. Now, insurers&nbsp;kind of said<em>,&nbsp;Whoa,&nbsp;we\u2019re&nbsp;not sure we like these things<\/em>.&nbsp;So&nbsp;yeah, you can use them, but it&nbsp;won\u2019t&nbsp;count towards your deductibles.&nbsp;So&nbsp;they\u2019re&nbsp;not&nbsp;nearly as&nbsp;useful as they might have been in the past. But patients are really stuck, because these are&nbsp;really expensive&nbsp;drugs that most people&nbsp;couldn\u2019t&nbsp;afford without copay cards.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>So&nbsp;what eventually happened to this patient, and how can other people avoid falling into the copay card trap?&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>So basically, because he had used up the amount on the copay card, which was&nbsp;$9,400 for the year,&nbsp;by the second month, he tried for the third month to kind of ration his drugs to take half as much, and his symptoms came back. And then the lucky thing for him was then it was January,&nbsp;right,&nbsp;copay cards&nbsp;are usually done for the year.&nbsp;So&nbsp;he got a new copay card for another $9,400 and he was good for January, and he paid with his health savings account for the first month\u2019s&nbsp;copay,&nbsp;with the copay card the second month, with the copay card and his health savings account. And when this went to press, he&nbsp;wasn\u2019t&nbsp;sure how he was going to pay for the rest of the year. And for him,&nbsp;it\u2019s&nbsp;not a huge problem, because he has a very&nbsp;well-funded&nbsp;health savings account, which few of us do, but he was&nbsp;really up&nbsp;in the air for the rest of the year when we wrote about this.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>So&nbsp;sort of moral of this story, be careful if you want to take an expensive drug, and the theory that when the drugmaker promises,&nbsp;<em>Oh, you can have this for as little as&nbsp;$0&nbsp;copay<\/em>.&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>Well, I&nbsp;think it\u2019s&nbsp;you have to understand what a particular card does.&nbsp;You have to understand what\u2019s the limit on how much is on the copay card.&nbsp;You have to understand how many months it\u2019s good for.&nbsp;You&nbsp;have to&nbsp;understand, from your insurer\u2019s point of view,&nbsp;if&nbsp;that will count as your deductible or not. And then, man, you know,&nbsp;you\u2019re&nbsp;kind of on&nbsp;your own,&nbsp;right?&nbsp;Sometimes your copay card will work great for you, and at other times it will work for a shorter amount of time. And you&nbsp;got&nbsp;to figure out what to do. I think the third,&nbsp;bigger lesson is getting biosimilars, which are these&nbsp;very expensive&nbsp;drugs approved,&nbsp;is not really the big problem in our country. The problem is the patent thickets that surround so many of these drugs that prevent them from getting to the patients who need them.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>In other words,&nbsp;you can make a copy of this drug, but you might not be able to get it onto the market.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>Right.<strong>&nbsp;<\/strong>You can make a&nbsp;copy&nbsp;this drug&nbsp;\u2014&nbsp;it&nbsp;[a generic]&nbsp;was approved in 2021&nbsp;\u2014&nbsp;but that won\u2019t help patients until 2028,&nbsp;which is really terrible. You know,&nbsp;it\u2019s&nbsp;available in other countries, but not here.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>So&nbsp;moving&nbsp;on,&nbsp;our March patient had insurance through the Affordable Care Act exchange and was&nbsp;benefiting&nbsp;from one of those zero-premium plans until she got caught in a&nbsp;literally Kafkaesque&nbsp;mess over a&nbsp;1-cent bill that turned into a&nbsp;5-cent bill. Who is she and what happened here?&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>Yeah, her name in this wonderful, terrible story is&nbsp;Lorena Alvarado Hill. And what happened here is she was on one of these $0 insurance plans through the Obamacare exchanges with that great subsidy, the Biden-era subsidy, and she and her mother were on the same plan, and her mother went on to Medicare,&nbsp;turned 65.&nbsp;So&nbsp;Lorena&nbsp;didn\u2019t&nbsp;need&nbsp;the family&nbsp;coverage and told the insurer that. And the insurance, of course, automatically recalculates your subsidy, and her premium went from being zero to&nbsp;1&nbsp;cent. Now,&nbsp;no human would make that, you know, would say,&nbsp;<em>Oh, that makes sense<\/em>. And to Lorena, it&nbsp;didn\u2019t&nbsp;really make sense either. She was like,&nbsp;I\u2019m&nbsp;not sure how to pay&nbsp;1&nbsp;cent, like, will it work on my credit card? And some of the bills said, you&nbsp;know,&nbsp;you understand that this could&nbsp;impact&nbsp;the continuation of your insurance, but, you know, she was like,&nbsp;<em>1&nbsp;cent,&nbsp;I&nbsp;don\u2019t&nbsp;think so<\/em>. And then she kept going to doctors, and the insurance still worked, and then at some point, four months later, she&nbsp;got&nbsp;a letter in November saying,&nbsp;<em>Oh, your insurance was canceled in July, and you owe money for all these bills<\/em>.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>And what happened with this case?&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>Well, you know, like many of our&nbsp;\u201cBill of the&nbsp;Month\u201d&nbsp;patients, I celebrate them for being real fighters, because her bill, since her premium was&nbsp;1&nbsp;cent a month, went from&nbsp;1&nbsp;cent to&nbsp;2&nbsp;cents to&nbsp;3&nbsp;cents to&nbsp;4&nbsp;cents to&nbsp;5&nbsp;cents,&nbsp;when they sent her the note saying your insurance has been canceled for the last four months.&nbsp;And what turns out, which is really interesting,&nbsp;is this is a known glitch in the way the subsidies were calculated, were administered.&nbsp;There\u2019s&nbsp;a recalculation of subsidies every time&nbsp;there\u2019s&nbsp;a life event, a kid goes off the plan, you change jobs, get married, you&nbsp;get divorced.&nbsp;So&nbsp;the recalculation&nbsp;happens automatically.&nbsp;And the Biden administration, understanding that this glitch could exist, they gave the insurers the&nbsp;option&nbsp;not to cancel insurance if the amount owed was less than $10.&nbsp;And there were&nbsp;apparently 180,000&nbsp;people caught in this situation where their insurance could have been canceled for under $10&nbsp;of a&nbsp;recalculated premium. The Trump administration revoked that rule because their feeling was, you owe something, you pay something.&nbsp;So&nbsp;it\u2019s&nbsp;part of their&nbsp;\u201cstamp out fraud and abuse,\u201d&nbsp;and this was, in their view, abuse of a system when people&nbsp;didn\u2019t&nbsp;pay what they owed.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;One cent.&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:<\/strong>&nbsp;One cent,&nbsp;right.&nbsp;So&nbsp;what happened&nbsp;with&nbsp;her is, you know,&nbsp;a&nbsp;good bill-paying&nbsp;citizen sending her daughter to college with loans. She wrote her insurers, she wrote to the state, she wrote to everyone. And as a last resort, of course, someone said,&nbsp;<em>Well,&nbsp;there\u2019s&nbsp;this thing called&nbsp;Bill of the&nbsp;Month you could write to<\/em>.&nbsp;So&nbsp;when we&nbsp;looked into&nbsp;this,&nbsp;at first&nbsp;HealthFirst, which was her insurer in Florida, said,&nbsp;<em>Oh,&nbsp;she&#8217;s&nbsp;not insured through us<\/em>.&nbsp;And I was like,&nbsp;<em>Yeah, because you canceled her insurance<\/em>. And then I gave them her insurance number, and they said,&nbsp;<em>Well, yes, according to law, we did the right thing.&nbsp;She&nbsp;didn\u2019t&nbsp;pay,&nbsp;so it was canceled<\/em>. Somehow, through all of this,&nbsp;word got back to the hospital and the insurer,&nbsp;and they worked together, and her bills were suddenly zero on her portal. So&nbsp;that\u2019s&nbsp;the good news for Lorena Alvarado&nbsp;Hill. It&nbsp;doesn\u2019t&nbsp;really help all those other people whose insurance may have been canceled for premiums that were under $10.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>So,&nbsp;basically, if you get a bill for&nbsp;5&nbsp;cents, you should pay it.&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:&nbsp;<\/strong>Yeah, you know, it was funny when this story went up, many&nbsp;people were sympathetic, but other commenters said,&nbsp;<em>Well, she should have just paid $1 because you can pay that<\/em>.&nbsp;And&nbsp;maybe there&nbsp;was a way to pay&nbsp;1&nbsp;cent. And&nbsp;I\u2019m&nbsp;kind of with&nbsp;her, like, if I got a bill for&nbsp;1&nbsp;cent, life is busy. This is a woman who is a teacher\u2019s aide and works on weekends at a store to help pay for her daughter\u2019s college. Life is busy. You just&nbsp;can\u2019t&nbsp;sweat over&nbsp;1-cent bills and spend a lot of time figuring out how to pay them. And&nbsp;I guess the lesson&nbsp;is,&nbsp;what\u2019s&nbsp;the worst that can happen in a very dysfunctional system where so much is automated&nbsp;now?&nbsp;The&nbsp;worst&nbsp;that can happen is always really bad. Your insurance could be canceled.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>So basically, stay&nbsp;on top of it, I guess,&nbsp;is the message for&nbsp;both of these&nbsp;stories this month. Elisabeth Rosenthal, thank you so much.&nbsp;<\/p>\n\n\n\n<p><strong>Rosenthal:<\/strong>&nbsp;Thanks,&nbsp;Julie,&nbsp;for having me.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>OK, we&nbsp;are back.&nbsp;It\u2019s&nbsp;time for our&nbsp;extra-credit&nbsp;segment.&nbsp;That\u2019s&nbsp;where we each recognize a story we read this&nbsp;week&nbsp;we think you should read,&nbsp;too.&nbsp;Don\u2019t&nbsp;worry if you miss it. We will post the links in our show notes on your phone or other mobile device. Jessie, why don\u2019t you go&nbsp;first this week?&nbsp;<\/p>\n\n\n\n<p><strong>Hellmann:&nbsp;<\/strong>My story is from&nbsp;The Texas Tribune, from a group of reporters who I&nbsp;can\u2019t&nbsp;name individually.&nbsp;There\u2019s&nbsp;too many of them. But it is&nbsp;<a href=\"https:\/\/www.texastribune.org\/2026\/03\/30\/texas-undocumented-immigrants-health-care-hospitals\/\" target=\"_blank\" rel=\"noreferrer noopener\">about how undocumented immigrants are avoiding medical care<\/a>&nbsp;in Texas after the governor issued an executive order a few years ago requiring that hospitals check patients\u2019&nbsp;citizenship.&nbsp;So&nbsp;the story found that hospital visits by undocumented people dropped by about a third, and the story also got into how this is bleeding into other types of health care at other facilities, free vaccine clinics are not being attended as widely anymore. People&nbsp;aren\u2019t&nbsp;attending their preventive care appointments,&nbsp;like cancer screenings or prenatal care checkups. Some of these other health facilities&nbsp;are required to&nbsp;check citizenship status, but&nbsp;it\u2019s&nbsp;definitely a&nbsp;chilling effect over the broader health&nbsp;care landscape in Texas.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah. There have been a lot of good stories about that. Sandhya.&nbsp;<\/p>\n\n\n\n<p><strong>Raman:<\/strong>&nbsp;My extra credit is from&nbsp;Science, and&nbsp;it\u2019s&nbsp;by Jocelyn Kaiser, and the story is&nbsp;\u201c<a href=\"https:\/\/www.science.org\/content\/article\/supporters-push-revive-moribund-agency-studying-patient-care\" target=\"_blank\" rel=\"noreferrer noopener\">Supporters Push To Revive Moribund Agency Studying Patient Care<\/a>.\u201d&nbsp;In her story, she talks about how last year, you know, the administration cut a lot of staff at the Agency for Healthcare Research and Quality. They\u2019ve canceled all of the open grants, but Congress still appropriated $345 million for the agency this year, and so supporters kind of want to revive what should be going on&nbsp;at&nbsp;the agency, which hasn\u2019t been issuing any of the grants since the start of the fiscal year, and just kind of make progress on some of the things that this agency does do, like running the U.S.&nbsp;Preventive Services Task Force, which has been, you know, something that has been talked about this year. So thought it was an interesting piece.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Yeah,&nbsp;I\u2019m&nbsp;old enough to remember when&nbsp;AHRQ&nbsp;was bipartisan. Alice.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>So&nbsp;a&nbsp;very harrowing story in The New York Times titled&nbsp;\u201c<a href=\"https:\/\/www.nytimes.com\/2026\/03\/26\/world\/americas\/cubas-health-system-us-oil-blockade.html\" target=\"_blank\" rel=\"noreferrer noopener\">Cuban Patients Are Dying Because of U.S. Blockade, Doctors Say<\/a>.\u201d&nbsp;And I will say, since this piece ran, we have seen that an oil shipment from Russia is going through to the island, but I don\u2019t think that will be sufficient to completely wipe away all of the upsetting conditions that this piece really gets into,&nbsp;what is happening as a result of the ramped-up U.S.&nbsp;embargo and blockade of the island. People&nbsp;can\u2019t&nbsp;get food, they&nbsp;can\u2019t&nbsp;get medicine, they&nbsp;can\u2019t&nbsp;get electricity, and that is having a devastating effect on health&nbsp;care. The Cuban health&nbsp;care system has been&nbsp;really miraculous&nbsp;over the years, just the pride of the government.&nbsp;It has meant,&nbsp;prior to this blockade,&nbsp;that their life expectancy was better than ours, and a lot of their outcomes were better. And&nbsp;so&nbsp;this has been really devastating. There\u2019s, you know, harrowing scenes of people on ventilators having to be hand-pumped when the electricity cuts out,&nbsp;babies&nbsp;in&nbsp;incubators, you know, losing power.&nbsp;You know, people&nbsp;having&nbsp;to skip medications, etc. And&nbsp;so&nbsp;this is really shining a light on a foreign policy situation that this administration&nbsp;is behind.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>Yeah,&nbsp;that\u2019s&nbsp;really been an under-covered story, too,&nbsp;I think, you know, right off our shores.&nbsp;My extra credit this week is one I simply could not resist.&nbsp;It\u2019s&nbsp;from New York Magazine, and&nbsp;it\u2019s&nbsp;called&nbsp;\u201c<a href=\"https:\/\/nymag.com\/intelligencer\/article\/pet-medical-tourism-tijuana-mexico-california-veterinarian.html\" target=\"_blank\" rel=\"noreferrer noopener\">The Dog Owners Taking Their Injured Corgis and Doodles to Tijuana:&nbsp;Mexico Is to Pet MRIs What Turkey Has Become for Hair Transplants<\/a>,\u201d&nbsp;by&nbsp;Helaine Olen. And as the headline&nbsp;rather vividly&nbsp;points out, we are&nbsp;witnessing&nbsp;the rise of pet medical tourism, along with human medical tourism, which has been a thing for a couple of decades&nbsp;now.&nbsp;It seems that veterinary medicine&nbsp;is getting&nbsp;nearly as&nbsp;expensive as human medicine, and that one way to find cheaper care is to cross the border, which is obviously easier if you live near the border.&nbsp;I\u2019m&nbsp;not sure how much cheaper veterinary care is in Canada, but as the owner of two corgis, I may have to do some investigating of my own.&nbsp;&nbsp;<\/p>\n\n\n\n<p>OK, that is this week\u2019s show.&nbsp;As always, thanks to our editor,&nbsp;Emmarie Huetteman,&nbsp;and our producer-engineer,&nbsp;Francis Ying.&nbsp;A&nbsp;reminder:&nbsp;<em>What the&nbsp;Health?<\/em>&nbsp;is now available on WAMU platforms, the NPR app,&nbsp;and wherever you get your podcasts&nbsp;\u2014&nbsp;as well as, of course,&nbsp;<a href=\"https:\/\/kffhealthnews.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">kffhealthnews.org<\/a>.&nbsp;Also,&nbsp;as always, you can email&nbsp;us&nbsp;your comments or questions.&nbsp;We\u2019re&nbsp;at whatthehealth@kff.org.&nbsp;Or you can find me still on X&nbsp;<a href=\"https:\/\/twitter.com\/jrovner\" target=\"_blank\" rel=\"noreferrer noopener\">@jrovner<\/a>, or on Bluesky&nbsp;<a href=\"https:\/\/bsky.app\/profile\/julierovner.bsky.social\" target=\"_blank\" rel=\"noreferrer noopener\">@julierovner<\/a>.&nbsp;Where are you folks hanging these days?&nbsp;Sandhya.&nbsp;<\/p>\n\n\n\n<p><strong>Raman:<\/strong>&nbsp;On&nbsp;<a href=\"https:\/\/x.com\/SandhyaWrites\" target=\"_blank\" rel=\"noreferrer noopener\">X<\/a>&nbsp;and on&nbsp;<a href=\"https:\/\/bsky.app\/profile\/SandhyaWrites.bsky.social\" target=\"_blank\" rel=\"noreferrer noopener\">Bluesky<\/a>&nbsp;<a href=\"https:\/\/bsky.app\/profile\/SandhyaWrites.bsky.social\" target=\"_blank\" rel=\"noreferrer noopener\">@SandhyaWrites<\/a>.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Alice.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:&nbsp;<\/strong>On Bluesky&nbsp;<a href=\"https:\/\/bsky.app\/profile\/alicemiranda.bsky.social\" target=\"_blank\" rel=\"noreferrer noopener\">@alicemiranda<\/a>&nbsp;and on X&nbsp;<a href=\"https:\/\/x.com\/aliceollstein?lang=en\" target=\"_blank\" rel=\"noreferrer noopener\">@AliceOllstein<\/a>.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong>&nbsp;Jessie.&nbsp;<\/p>\n\n\n\n<p><strong>Hellmann:<\/strong>&nbsp;I\u2019m&nbsp;on LinkedIn under Jessie Hellmann&nbsp;and on X&nbsp;<a href=\"https:\/\/twitter.com\/jessiehellmann\" target=\"_blank\" rel=\"noreferrer noopener\">@jessiehellmann<\/a>.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:&nbsp;<\/strong>We\u2019ll&nbsp;be back in your feed next week. Until then, be healthy.&nbsp;<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/section>\n\n\n\n<div class=\"wp-block-credits block--credits\">\n\t\t<h3 class=\"credits-title\">\n\t\tCredits\t<\/h3>\n\t\t<div class=\"credits-card-container twowide\">\n\t\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Francis Ying<\/div>\n\t<div class=\"author-affiliation\">Audio producer<\/div>\n\t\t\t\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Emmarie Huetteman <\/div>\n\t<div class=\"author-affiliation\">Editor <\/div>\n\t\t\t\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<p><em><a href=\"https:\/\/kffhealthnews.org\/our-podcasts\/\"><u>Click here to find all our podcasts.<\/u><\/a><\/em><\/p>\n\n\n\n<p><em>And subscribe to &#8220;What the Health? From KFF Health News&#8221; on <a href=\"https:\/\/podcasts.apple.com\/us\/podcast\/what-the-health\/id1253607372?mt=2\"><u>Apple Podcasts<\/u><\/a>, <a href=\"https:\/\/open.spotify.com\/show\/32EdsB662C3oyIrqLMmBXI?si=TQhRjzzLTgWtK3crfbOFtA\"><u>Spotify<\/u><\/a>, <a href=\"https:\/\/app.npr.org\/aggregation\/fis-1269164038\"><u>the NPR app<\/u><\/a>, <a href=\"https:\/\/www.youtube.com\/playlist?list=PL5Qew-7pSXbAucCUQnyRx6qpLglzrxzFb\" target=\"_blank\" rel=\"noopener\">YouTube<\/a>, <a href=\"https:\/\/play.pocketcasts.com\/web\/podcasts\/a379e280-3f57-0135-9028-63f4b61a9224\"><u>Pocket Casts<\/u><\/a>, or wherever you listen to podcasts.<\/em><\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Despite public opposition to the cuts they made to federal health programs in 2025, Republicans reportedly are considering more cuts to help pay for the war in Iran. Meanwhile, the Supreme Court ruled that Colorado cannot ban \u201cconversion therapy\u201d for LGBTQ+ minors. Jessie Hellmann of CQ Roll Call, Alice Miranda Ollstein of Politico, and Sandhya Raman of Bloomberg Law join KFF Health News\u2019 Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF Health News\u2019 Elisabeth Rosenthal, who wrote the last two \u201cBill of the Month\u201d stories.<\/p>\n","protected":false},"featured_media":2103181,"template":"","meta":{"_cr_original_post":"2103176","_cr_replace_post_id":"","_cr_replacing_post_id":"","jetpack_post_was_ever_published":false,"kaiser_health_news_featured_image_caption":"","kaiser_health_news_header_theme_slug":"","kaiser_health_news_hero_image":0,"kaiser_health_news_backdrop_padding":115,"kaiser_health_news_kicker":"What the Health? 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Also this week, Rovner interviews KFF Health News\u2019 Elisabeth Rosenthal, who wrote the last two \u201cBill of the Month\u201d stories.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/kffhealthnews.org\/news\/podcast\/what-the-health-440-gop-health-cuts-iran-april-2-2026\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"GOP Mulls More Health Cuts - KFF Health News\" \/>\n<meta property=\"og:description\" content=\"Despite public opposition to the cuts they made to federal health programs in 2025, Republicans reportedly are considering more cuts to help pay for the war in Iran. Meanwhile, the Supreme Court ruled that Colorado cannot ban \u201cconversion therapy\u201d for LGBTQ+ minors. 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