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KHN’s ‘What the Health?’: Expanding the ACA in an Unpredicted Way
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KHN’s ‘What the Health?’: Expanding the ACA in an Unpredicted Way


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For the first time since its enactment in 2010, the Affordable Care Act is slated for major benefit expansions, courtesy of the covid relief bill approved by Congress this week. But the changes are only temporary, so the measure also tees up a fight to make them permanent.

Meanwhile, the uneven distribution of vaccines continues — with some states finding themselves with more shots than takers, while others continue to have too many arms chasing too few shots. And the Centers for Disease Control and Prevention is caught in the middle — trying to issue guidelines that will encourage people to see the vaccine as a ticket to a freer life, while not encouraging dangerous behavior as the coronavirus — and its more transmissible variants — is still spreading widely.

This week’s panelists are Julie Rovner of KHN, Tami Luhby of CNN, Alice Miranda Ollstein of Politico and Rachel Cohrs of Stat.

Among the takeaways from this week’s podcast:

  • The ACA benefits in the covid relief bill include more generous subsidies and added benefits for a wider group of Americans. But the test for Democrats will be whether they can persuade the country — and the Congress — to make the changes permanent.
  • That bill also makes substantive changes in Medicaid rules. It offers states that have not expanded the health care program for low-income people — a provision of the ACA — a financial incentive to do so. It also allows states to extend postpartum coverage to enrollees from 60 days to one year. Advocates hope this will help lower high rates of maternal deaths in the U.S.
  • Other programs that affect health are also strengthened by the bill, including an increase in food stamp benefits, continued unemployment benefits for gig workers, assistance to people facing eviction and major changes in the child tax credit that will send government checks to many families across the country, including people who in the past did not get the credit because they earned too little to file taxes.
  • A final vote on the nomination of Xavier Becerra to be the next secretary of the Department of Health and Human Services is expected in the Senate soon. If Becerra is confirmed, it could break the logjam to get other health officials confirmed and on the job.
  • Recent polling has suggested that Republicans, in particular, are hesitant to get vaccinated. Often public health advocates turn to opinion leaders or celebrities to help deal with hesitancy in specific populations, but it’s not clear who could be that spokesperson in this case since Republicans are split on the best way to fight the virus.

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

Julie Rovner: The New York Times’ “After Testing Negative for the Coronavirus, an Uninsured Man Wasn’t Eligible for Help With His $22,368 Hospital Bill,” by Sarah Kliff

Alice Miranda Ollstein: The New Yorker’s “L.A.’s Disorganized Vaccination Rollout and the Dream of Universal Health Care,” by Emily Witt

Tami Luhby: Vox.com’s “A New Democratic Plan to Expand Medicaid Hits a Big Snag: Republican Governors,” by Dylan Scott

Rachel Cohrs: The New York Times’ “How One Firm Put an ‘Extraordinary Burden’ on the U.S.’s Troubled Stockpile,” by Chris Hamby and Sheryl Gay Stolberg


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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.