KHN’s ‘What the Health?’: Voters Will Get Their Say on Multiple Health Issues

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Voters in several states will be asked to vote on ballot questions related to abortion, but it’s not the only health issue that will be decided on Election Day. Other ballot proposals will ask voters whether they want to curb interest on medical debt (Arizona), expand Medicaid (South Dakota), or make health care a right under the state constitution (Oregon).

Meanwhile, plaintiffs in a suit charging that the Affordable Care Act’s requirement to provide preventive medication against HIV are expanding their scope. Now they want the judge to rule that all preventive benefits under the health law are unconstitutional.

This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Jessie Hellmann of CQ Roll Call, and Victoria Knight of Axios.

Among the takeaways from this week’s episode:

• The South Dakota ballot measure is the latest effort by health care advocates in conservative states to get a Medicaid expansion despite resistance from state officials. South Dakota’s governor and state legislature have refused to make the move. In recent years, voters in several of those states, including Idaho, Missouri, and Utah, have pushed the expansion forward over officials’ objections through voter initiatives.
• Arizona’s unique ballot measure would limit interest rates on medical debt, among other things. It’s a bit of an under-the-radar issue, but if Arizona passes the measure, it could spur other states to try similar initiatives.
• A handful of states will also be voting on abortion issues. In Kentucky, the legislature has put forward a constitutional amendment that says abortion rights aren’t protected by the state constitution and that government funding for abortions is not required. Voters in another red state, Kansas, surprised political pundits last summer when they overwhelmingly voted to maintain the right to abortion access, so the Kentucky results will be watched closely. If voters disapprove of the measure, it would be the first Southern state where voters have turned against the tide of legislation seeking to restrict abortion.
• On the other hand, two reliably blue states — California and Vermont — are asking voters to enshrine a right to abortion in the states’ constitutions. Debate on the ballot measures, however, has raised the question of whether fetal viability should be a standard for when an abortion can’t be performed. Neither the groups supporting wide access for abortion rights nor those opposing abortion have said they are comfortable making a decision on abortion by using a viability standard.
• In Washington, D.C., news, the Department of Defense’s announcement that it would pay travel expenses and provide leave for servicemembers seeking abortions out of state is likely to rile Republicans on Capitol Hill. It could also make the final negotiations tense over a defense spending bill that needs to be settled before the end of the year. The tone of those talks will likely depend on the election results next month.
• The suit in federal court in Texas challenging the ACA’s preventive care mandates continues to grow. Judge Reed O’Connor has already ruled that the plaintiffs’ religious views should exempt them from having to provide some preventive care, including certain HIV drugs. It may yet take months to realize the implications of the case, but the plaintiffs have asked the judge to strike down all the preventive care provisions and to make the ruling applicable across the country. If that happens, the case will undoubtedly be appealed.
• Studies out this week show that the covid-19 pandemic had a nasty aftereffect for children: Test scores have dropped around the country. And an analysis by The Washington Post found that the covid death rate among white Americans is now higher than among Black residents. These data points add to concerns this fall as public health officials face difficulty encouraging people to get the latest covid booster, let alone their flu shot.

Also this week, Rovner interviews Sandra Alvarez, writer, director, and co-producer of the documentary “InHospitable,” which looks at the growing market power of nonprofit hospitals and how well they serve their patients and their communities.

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

Julie Rovner: The Washington Post’s “An Autistic Teen Needed Mental Health Help. He Spent Weeks in an ER Instead,” by William Wan

Alice Miranda Ollstein: CBS News’ “U.S. Offers Flu Shots to Migrants in Border Custody, Reversing Long-Standing Policy,” by Camilo Montoya-Galvez

Victoria Knight: Stat’s “Inside Michelle McMurry-Heath’s Departure From BIO: Firings, Internal Clashes, and a Pivotal Job Review,” by Rachel Cohrs

Jessie Hellmann: KHN’s “Hospitals Said They Lost Money on Medicare Patients. Some Made Millions, a State Report Finds,” by Fred Clasen-Kelly

Also mentioned in this week’s episode:

The Washington Post’s “Whites Now More Likely to Die From Covid Than Blacks: Why the Pandemic Shifted,” by Akilah Johnson and Dan Keating

Bloomberg Law’s “Law Firm Calls Out Ex-EEOC Counsel’s Note on Abortion Travel,” by Rebecca Rainey and J. Edward Moreno

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This story was produced by KHN (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.