The Host
Julie Rovner
KFF Well being Information
Julie Rovner is chief Washington correspondent and host of KFF Well being Information’ weekly well being coverage information podcast, “What the Well being?” A famous skilled on well being coverage points, Julie is the creator of the critically praised reference ebook “Well being Care Politics and Coverage A to Z,” now in its third version.
On September 2, 1974, President Gerald Ford signed into regulation the Worker Retirement Revenue Safety Act, higher often known as ERISA. Whereas the regulation was primarily meant to manage and defend employee pensions, it additionally basically modified how medical health insurance is supplied and controlled in the US. Fifty years on, ERISA performs a task in almost each element of medical health insurance and has had a profound impression on all the well being care sector.
To notice this anniversary, on this week’s particular episode of KFF Well being Information’ “What the Well being?”, host and KFF Well being Information chief Washington correspondent Julie Rovner discusses the regulation’s previous, current, and future with three consultants on ERISA: Larry Levitt of KFF, a well being data nonprofit that features KFF Well being Information; Paul Fronstin of the Worker Profit Analysis Institute, a nonprofit; and Ilyse Schuman of the American Advantages Council, a commerce group advocating for employers that sponsor employee profit plans.
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Transcript: Joyful fiftieth, ERISA
KFF Well being Information’ ‘What the Well being?’ Episode Title: ‘Joyful fiftieth, ERISA’ Episode Quantity: 360Revealed: Thursday, Aug. 15, 2024
[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]
Julie Rovner: Good day, and welcome again to “What the Well being?” I’m Julie Rovner, chief Washington correspondent for KFF Well being Information. Normally, I’m joined by a number of the finest and smartest well being reporters in Washington, however right now, we’ve a particular episode for you. We’re taping this week on Monday, Aug. twelfth, at 2 p.m. As all the time, information occurs quick, and issues may’ve modified by the point you hear this — though this time, I hope not. So right here we go.
So for those who comply with well being coverage, you’re seemingly aware of the massive federal legal guidelines which have formed how well being care within the U.S. is organized and delivered and paid for. Medicare and Medicaid in 1965, HIPAA in 1996, and the Inexpensive Care Act in 2010, simply to call just a few.
One chances are you’ll not have heard as a lot about is ERISA, the Worker Retirement Revenue Safety Act, which was signed in 1974 by then-President Gerald Ford. This fall marks 50 years since ERISA turned regulation. ERISA, as its identify suggests, is usually about defending pension advantages for staff. It was impressed, no less than partly, by the collapse of a pension fund when a plant that constructed Studebaker vehicles in Ohio shut down in 1963. However, no less than as legend has it, on the final minute within the Home-Senate Convention in 1974, somebody determined so as to add well being advantages to ERISA’s scope, and that actually modified the whole lot of how well being advantages are regulated within the U.S.
I’m happy to have an all-star panel right here to hitch us to speak about what ERISA has meant to well being coverage and what it’s more likely to imply going ahead because it begins its second half-century. Larry Levitt is govt vp for coverage right here at KFF and one in all only some individuals within the group even nerdier than I’m about issues like ERISA. Paul Fronstin is director of well being advantages analysis on the Worker Profit Analysis Institute, a nonpartisan assume tank that does analysis and schooling. Paul has additionally taught me extra about ERISA through the years than most likely some other single individual.
Lastly, Ilyse Schuman is senior vp of the American Advantages Council, which represents giant employers and different suppliers of well being and retirement advantages by means of employer-sponsored plans. Ilyse additionally spent a number of years on Capitol Hill engaged on the Senate committee that oversees ERISA coverage. So, loads of information right here in our podcast field. Thanks for all of you for being right here.
Ilyse Schuman: Thanks
Larry Levitt: Nice to be right here.
Rovner: So let’s begin originally. How did well being advantages wind up being lined in a regulation that was geared toward retiree pensions?
Paul Fronstin: None of us have been right here or there on the time, so I believe something we all know is second- or third-hand data. And such as you mentioned, the availability was inserted on the final minute, however I believe there have been loads of conversations about it main as much as it being inserted on the final minute. I believe loads of it needed to do with some tensions between state regulation and federal regulation, as a result of there have been self-insured well being plans in existence and self-insured advantages extra usually in existence earlier than ERISA handed.
And clearly these plans wished some federal safety relating to what they have been doing, and the states wished extra regulation. And I’ve learn a little bit bit about this through the years, and there was actually some lobbying for and towards having a provision in there to guard self-insured plans from state regulation. So the conversations have been occurring. It simply … the language most likely simply didn’t make it into the laws until the final minute.
Schuman: And I believe actually the panorama again in 1974, as Paul talked about, was that an increasing number of states have been creating, with respect to well being care, their very own variations of assorted legal guidelines. And so self-funded plans, giant employers like our members — plenty of them have been again in existence 50 years in the past, some weren’t — have been discovering it more and more troublesome to have the ability to administer their self-funded plans on a uniform foundation nationwide.
So it wasn’t within the backrooms once they have been really drafting the laws, however actually notice that the nationwide panorama on this rising patchwork of state well being legal guidelines was changing into more and more problematical for self-funded well being plans.
Levitt: Yeah. I imply, this was additionally a interval when medical health insurance was altering fairly dramatically. I imply, earlier than this time medical health insurance was fairly easy. It was known as indemnity insurance coverage, proper.
You went to the physician, you went to the hospital, you bought a declare, you filed it along with your insurance coverage firm, and so they paid 80% of it. This was a time when PPOs [preferred provider organizations] have been beginning, managed care, HMOs have been actually simply getting their begin. So there was a necessity for rather more regulation as a result of insurance coverage was getting extra sophisticated.
Fronstin: Yeah. To some extent, the HMO Act of, what, 1973, proper, simply the yr earlier than. So HMOs have been simply approaching the scene, and which will have performed into this as nicely.
Rovner: So again in 1945, when actually none of us have been within the room, Congress handed one thing known as the McCarran-Ferguson Act, which was supposed to make sure that states relatively than the federal authorities retained the authority to manage insurance coverage. What occurred in ERISA to alter that? Ilyse, I believe you have been already kind of referring to this. And what can we imply after we speak about ERISA preemption? That’s a phrase that folks hear lots and their eyes glaze over.
Schuman: Positive. Properly, their eyes could glaze over however it actually is foundational to hundreds of thousands of Individuals and their households which can be lined by employers who determine that they need to self-fund their plans. That implies that they’re those that determine that, “Hey, we’re going to take the danger as providing these advantages as a substitute of the service.”
Rovner: In order that they’re not really shopping for insurance coverage as a result of …
Schuman: That’s …
Rovner: … they’re paying the payments.
Schuman: They’re doing extra than simply paying the invoice. They’re those which can be in the end assuming the dangers of these claims, too. And I believe the worth. So possibly — simply to step again earlier than we speak about what a preemption is — is what we speak about employers who determine to self-fund versus people who don’t. Admittedly, lots of people who self-fund are bigger employers, however once more, they are saying that “We are going to take the danger of paying for the claims of our medical health insurance protection as a substitute of the service. However together with that, we get the pliability and we get the power to design and implement well being protection that we expect meets the wants of our inhabitants. That’s enabled us to” — talking once more from self-funded employers — “to implement progressive designs with the assurances that they might implement these, they might administer that on a uniform foundation nationwide.” In order that’s actually what we’re speaking about. Preemption is the power of self-funded employers to manage these advantages on a uniform foundation nationwide.
And sure, getting again to McCarran-Ferguson, and if you wish to speak by means of the kind of numerous layers of ERISA preemption, is there’s one thing known as the financial savings clause, which is OK. So ERISA says: “First threshold stage, we’re going to preempt state legal guidelines.” However there’s a financial savings provision that claims mainly: “In case you’re within the enterprise of insurance coverage, states can regulate that.” However then there’s this deemer clause — that is actually nerdy now, so a few of your viewers could also be questioning right here what we’re speaking about …
Rovner: I bear in mind studying this many, a few years in the past.
Schuman: No. Yeah. So for those who’re in regulation college, take notice that the deemer clause implies that self-funded group well being plan is deemed to not be within the enterprise of insurance coverage; which means that they don’t need to adjust to these state insurance coverage legal guidelines.
Levitt: And right here’s the place this will get actually tangible for individuals, proper? So 150 million individuals have insurance coverage protection by means of an employer. It’s the largest supply of well being protection. However 65% of them are in self-insured plans, like Ilyse was speaking about. And people self-insured plans are exempt from state regulation.
So if a state is regulating insurance coverage, let’s say mandating advantages, mandating protection of IVF, mandating protection of preventive care, mastectomies, no matter — these laws that states are putting in don’t apply to most individuals with employer-sponsored insurance coverage as a result of they’re in these self-funded plans.
Rovner: And, after all, the persevering with issues that lots of people who’re in these self-funded plans don’t comprehend it as a result of they’ve an insurance coverage card and it says Blue Cross or Aetna or no matter, as a result of, of their case, they’ve an insurance coverage card, however the insurer will not be offering insurance coverage, proper?
Levitt: No, it’s outstanding. We did a survey of shoppers about their experiences with medical health insurance. And we requested them, “What authorities company do you assume you’ll flip to with an issue along with your insurance coverage?” And actually zero individuals mentioned the Division of Labor, which is the federal government company that really enforces ERISA.
Rovner: However I suppose what I used to be asking about are third-party directors, which I believe most individuals have by no means heard of till they uncover that they’re not topic to their state’s requirement.
Levitt: Completely. I imply, it will get actually complicated, proper? As a result of it is likely to be that UnitedHealthcare is administering this self-funded plan, however you, as an worker on this plan, don’t have any method of actually understanding is {that a} self-insured plan administered by UnitedHealthcare? Or is that an insurance coverage plan administered by UnitedHealthcare? After which there are these third-party directors that you simply’ve by no means even heard of which can be administering them for a lot of employers.
Rovner: Paul, you wished so as to add one thing.
Fronstin: We have to distinguish between ERISA and self-insured plans, proper, as a result of they’re not one and the identical. ERISA additionally covers totally insured plans.
Schuman: Proper.
Fronstin: So totally insured plans are regulated each by ERISA and on the state stage. And then you definately’ve acquired some self-insured plans like authorities plans that aren’t lined by ERISA, proper? However they’re self-insured. So it’s much more sophisticated than what we’re making it out to be after we speak about ERISA, preemption, and self-insurance. That’s only one side of ERISA.
Schuman: And I believe to the purpose about workers unsure what covers them, what doesn’t cowl them. Once more, for self-funded giant employers, I imply, I believe a lot of the workers perceive from their employer, from the group well being plan, what the phrases of the plan are, and what the advantages are. And I believe in some methods, maybe much less advanced than, OK, for those who’re an worker working in Kentucky, you may have one plan. In case you’re an worker working in New York, you may have one other plan. And workers speaking to one another and saying, “Hey, how come you may have that and I don’t have this?”
So I believe that the readability or the consistency is vital not only for employers who’re administering the plan, however for workers understanding what the phrases of the plans are. And likewise, two issues about kind of the advantages and what’s lined. There’s a distinction between a state saying, “OK, it’s important to cowl this profit and need to cowl it in exactly this fashion” versus employers who say, “Look, it’s actually vital for our inhabitants, to be wholesome and productive, to have these advantages, and so we’re going to supply this profit. We’re simply going to do it in the identical method nationwide.”
And bear in mind, ERISA, if the federal authorities, because it has accomplished over the previous, needs to make adjustments to … which can be relevant to group well being plans, it may well amend and has amended ERISA to try this. So the market reforms, for instance, within the Inexpensive Care Act, have been relevant, and the Public Well being Service Act, have been kind of included into ERISA. The Genetic Info Nondiscrimination Act, for instance, amended ERISA. So it’s like that’s the lever to make adjustments to ERISA that can be relevant to self-funded plans as nicely is on the federal stage.
Rovner: Once I was first protecting Congress within the 19… late-Eighties and early-Nineties, you didn’t go there. In case you wished to do one thing about well being coverage, you didn’t contact ERISA. I believe lawmakers have been afraid of reopening it and stepping into every kind of fights. Why did that lastly change?
Levitt: I imply, I believe there was a rising recognition, significantly with the Inexpensive Care Act, that there have been just a few minimal thresholds that well being protection needed to meet to be reliable protection. So for those who have a look at what the ACA did, and as Ilyse mentioned, these utilized to all employers, all group well being plans by means of the amendments to ERISA.
And these have been issues like no preexisting situation exclusions, protection of preventive providers with no affected person price sharing, no annual on lifetime limits, a cap on out-of-pocket prices. And doubtless the preferred provision of the ACA, protection of dependents as much as age 26. There was no approach to attain everybody with insurance coverage with out amending ERISA beneath the Inexpensive Care Act.
Fronstin: Yeah. However there have been examples, pre-ACA, that affected all plans, or most plans, like psychological well being parity we didn’t point out. Properly, there’s been a few situations of that. And definitely the Clinton well being plan tried this and didn’t succeed within the early Nineties.
Rovner: And HIPAA …
Levitt: I imply …
Rovner: … which was, I suppose, the primary main stroll into ERISA since ERISA had been handed.
Levitt: Proper. And even COBRA. The flexibility to proceed your insurance coverage after you allow an employer was an modification to ERISA.
Rovner: That’s proper. And that was in 1986.
Fronstin: Yeah, and even that could possibly be complicated as a result of it exempts smaller employers, proper. However you bought the mini-COBRA legal guidelines at state stage that have an effect on a few of these employers, however not each state has one.
Rovner: Yeah. And Paul, you have been referring to this. We should always most likely speak about who’s not topic to ERISA as a result of I don’t assume anyone talked about church plans. There’s a rule, after which there’s all these exceptions.
Fronstin: I believe the 2 main classes are church plans, and I’m unsure we also have a good deal with on how many individuals are lined by church plans as a result of loads of them are usually small companies, and so they could not even supply protection. And federal, state, and native authorities. I’m unsure if there’s one other class in there that’s not lined by ERISA. I consider that the state and native governments have their very own regulation that’s just like ERISA, however it’s not ERISA.
Schuman: And I believe after we speak about lined by ERISA, actually it’s, What does ERISA afford? It’s not nearly self-funded employers having the ability to supply uniform advantages nationwide. There are vital protections. There are vital disclosure necessities for workers, for contributors which can be included in there which can be relevant to all ERISA plans, self-funded and insured plans, and clearly on the retirement plans, too.
However I simply assume it’s actually vital that we glance to see the concept behind ERISA was that, sure, there can be this uniformity for self-funded plans. However for all ERISA plans, there are these protections and safeguards in there which can be embedded within the regulation for the advantage of contributors.
Rovner: And that’s why you used to get a phone-book-thick, “That is your plan documentation.” Now, it’s all on-line, and it’s all in 4-point sort. However that’s the place that comes from, proper? On the requirement that you simply be instructed every thing that your plan covers.
Schuman: Proper. Appropriate.
Rovner: So, Larry, you type of referred to this earlier. Self-funded ERISA plans are regulated not by the states however by the Division of Labor, which most individuals don’t know. And for a very long time, for those who have been injured or somebody died because of being denied care, the one factor that they might get well was the price of the care that was denied. Not any damages for what occurred. When did that lastly change? And has it lastly modified? What do you do now for those who’re injured — you’ll be able to’t go to your state regulatory company?
Levitt: No, there have been some adjustments to that, however enforcement of ERISA continues to be comparatively gentle on the administrative stage in comparison with what state insurance coverage departments do. And the Division of Labor simply appears very far-off to individuals in comparison with a state insurance coverage division.
I believe it’s actually this construction of ERISA that, Julie, you mentioned individuals have been all the time immune to amending in Congress, that has been immune to modification, proper? I imply, this concept that states regulate insurance coverage straight however that states can’t regulate group well being plans beneath ERISA. And that’s had far-reaching well being coverage implications. So states seeking to do employer mandates or something that straight impacts these group well being plans, employer well being plans, and that’s possibly …
Rovner: Additionally, states seeking to do single-payer plans, proper?
Levitt: Yeah. No, I imply, single-payer there is likely to be some methods round ERISA by means of single-payer and taxation, however ERISA has been a barrier to state well being reform efforts, for higher or for worse.
Schuman: If possibly we are able to simply step again 50 years, I believe it’s … I wrote down this quote from one of many authors of ERISA, particularly on the ERISA preemption, and that was by Rep. John Dent, who was a Democrat from Pennsylvania who recognized the ERISA preemption because the regulation’s crowning achievement.
And he mentioned it was the crowning achievement as a result of, with out it, the laws wouldn’t have loved the assist of each labor and administration because it’s so elementary for the power of multistate employers to sponsor profit plans to staff nationwide. So I believe simply type of getting again into the minds of the drafters of ERISA, that cut price, if you’ll, that turned ERISA preemption was actually foundational to the regulation passing.
Rovner: And you can see why it will make sense. In case you work for a nationwide firm and also you get transferred from one state to a different, your insurance coverage shouldn’t change dramatically.
Schuman: Yeah. And I believe fast-forward 50 years, and we’ve acquired, actually, post-pandemic or after the pandemic, an more and more cell and distant workforce. And we’ve heard repeatedly about how ERISA preemption actually promotes that employee mobility and the power to work out of your own home in one other state or to have the ability to switch from one location to a different.
So assume a little bit bit if we simply see how the workforce itself has advanced, I believe that ERISA preemption provision could turn out to be much more vital. And I believe more and more, it’s not simply giant employers that discover themselves — like nationwide or multistate employers — however as a result of the workforce is extra distant and cell, and needs to be, that an increasing number of employers of multistate employers, too.
Levitt: I might say we’ve more and more seen smaller employers self-funding, and there are some benefits to that, proper? They don’t essentially need to pay premium taxes to states, and they’re exempt from state profit mandates that apply over and above past the Inexpensive Care Act. I imply, insurers have give you very inventive methods of permitting smaller companies to self-fund and avoiding a number of the threat by layering a lot of reinsurance on high of that.
Fronstin: I used to be going to say, together with self-funding comes ease of administration right here. Ilyse, you name it uniformity of advantages. However I consider employers, they don’t need to offer 50 completely different well being plans in 50 completely different states. And to the diploma you’ve acquired the states doing one thing — whether or not it’s a single-payer or one thing wanting that — employers, they simply need to supply everybody the identical profit and make it as straightforward as potential to take action.
And my concern is that if they needed to adjust to 50 completely different state legal guidelines to take action or create 50 completely different profit plans, particularly right now with the ACA assured problem and backed protection, you’ll get to the purpose the place if employers didn’t have the power to supply one profit plan throughout all 50 states, they’re not going to do it anymore, proper? They’ve acquired … pre-ACA may’ve been completely different, however now they’ve acquired an alternate the place their workers might get protection in the event that they didn’t supply protection themselves.
Rovner: In order that was all predicted. This enormous motion away from employer-provided protection after the ACA handed was predicted, and it didn’t occur.
Fronstin: I used to be a kind of individuals predicting it. Yeah. Earlier than the ACA handed, I used to be a kind of individuals predicting it. And I believe what occurred is: One, being employers, they nonetheless worth the profit. They nonetheless perceive there are enterprise causes to supply it, and so they haven’t had excuse to eliminate it.
We haven’t had — aside from the recession tied to covid — we haven’t had a recession. Our unemployment price has been at traditionally low charges. And I believe employers, they don’t need to mess with one thing that’s working for essentially the most half as a result of they use it to recruit and retain workers for a similar factor they have been doing again within the Nineteen Forties and ’50s once they first began providing it.
Schuman: I believe it’s vital to delineate the employer voice in right here. And I believe possibly there’s a notion that employers are simply writing the checks or employers and well being plans are type of conflated. However employers are doing much more than simply writing a test. And I believe these, once more, which have determined to self-fund need to have the ability to have management over how they’re spending their well being care {dollars}. So once more, they will attempt to drive extra inexpensive, higher-value, higher-quality well being care.
And so it’s not nearly who writes the test, however the causes behind employers saying, “Hey, we’re going to be spending … we spend an entire lot of cash on our well being advantages as a result of we acknowledge that it’s good enterprise. It’s good for workers. However we wish to have the ability to have the power to attempt to drive enhancements in that to drive higher-value care.” And in order that’s enabled by ERISA. So the well being reforms and the well being innovation, actually there’s lots coming from the states, however there’s lots coming from employers, too.
Rovner: So what are the massive points going ahead for ERISA? I imply, clearly, there’s nonetheless, for those who Google ERISA, you get every kind of lawsuits and challenges. And I imply, it’s nonetheless a really vigorous a part of the regulation 50 years on.
Levitt: I imply, I believe, Julie, you talked about these lawsuits, and that’s doubtlessly an enormous problem going ahead. One thing known as the Consolidated Appropriations Act added some transparency in charges that self-insured employer plans paid to suppliers. And that’s opened the door to some lawsuits difficult whether or not group well being plans, ERISA plans, are performing as acceptable fiduciaries in attempting to get the bottom prices, significantly for pharmaceuticals. And these began out as type of a fringe motion, however I believe pose some potential dangers for group well being plans.
Rovner: Ilyse, what are employers most involved about?
Schuman: Properly, I believe that employers seeing the rising variety of states which can be attempting to chip away, if not erode in a elementary method, ERISA preemption is actually alarming. A variety of these efforts have come up round pharmacy profit managers and efforts to manage pharmacy profit managers on the state stage.
However the way in which that they’ve accomplished it, the states have actually taken direct intention at ERISA preemption and self-funded plans and, I believe, has a lot broader implications for self-funded group well being plans past simply the PBM context. And so I believe that they’re wanting on the rising variety of states which can be serious about passing legal guidelines that actually erode ERISA preemption as very alarming.
Rovner: So I need to go across the desk earlier than we finish. Type of what do you assume has been the largest impression on the well being system of ERISA, each for good and for not so good? I imply, it’s actually one of many issues that makes it so complicated to know and clarify. Larry, you need to go first?
Levitt: I believe the largest impression of ERISA has been placing the brakes on some state well being reform efforts. States have discovered methods to get round it. Some increase some points for employers, like Ilyse was saying, however it has actually circumscribed what states can do round well being reform. That mentioned, ERISA has supplied a really secure regulatory atmosphere for employers and certain allowed employer protection to develop over time in that atmosphere.
Rovner: Paul?
Fronstin: Yeah, I’d say, along with that, it’s allowed employers to be progressive. Not each self-insured employer has been progressive, proper? And there’s one thing like 1,000,000 employers on the market with a thousand or extra workers. And the smaller of these will not be essentially being progressive, however they’re studying from the biggest ones, proper? The jumbo employers, who’re attempting to do various things relating to participating the well being system, proper? Participating hospitals and physicians and pharmaceutical managers.
And I believe that that … the teachings discovered from what they’re doing trickles right down to the smaller self-insured employers, and it trickles out to the well being insurers which can be providing totally insured plans to small employers.
Rovner: Ilyse.
Schuman: I believe ERISA has allowed employers to supply value-driven, complete, inexpensive, higher-quality well being protection to working households throughout the nation — 150 million, 180 million, guess it relies upon what stats you’re taking a look at, and that it’s withstood the take a look at of time.
And I believe that most likely no stressor, just like the pandemic, the place many questioned what would emerge from that, and with some dents, but in addition with loads of silver linings by way of employers providing advantages to assist their workers navigate by means of the pandemic. And so I believe there’s a resiliency to the employer-sponsored system coupled with the innovation that Paul has talked about.
Rovner: Final query. Sure or no? Is ERISA going to be round in one other 50 years? In different phrases, are we nonetheless going to have this technique of well being protection? I promise I cannot maintain you to it. Simply finest guess. Larry.
Levitt: I say no.
Rovner: Paul.
Fronstin: I reply “don’t know.”
Rovner:: That’s OK. Ilyse.
Schuman: Properly, I’ll say that I only recently acquired a tortoise for my household that I’ve discovered will stay 50 or 100 years, so past me. So will ERISA be round so long as Veggie, the tortoise? I don’t know.
I believe that there’s actually an vital inflection level. And I believe if addressing a number of the underlying drivers of rising well being care prices and consolidation, I believe that if these are addressed, I believe employer-provided protection actually has the power to face up to the take a look at of time over the subsequent 50 years.
Rovner: Good. Thanks all a lot. This has been nice.
Schuman: Thanks lots.
Levitt: Nice. Thanks, Julie.
Schuman: Thank your crew.
Levitt: Thanks all.
Schuman: Bye-bye.
Fronstin: Take care, everyone.
Levitt: Bye.
Rovner: Bye. OK, that’s our ERISA anniversary present. Huge because of our company, Larry Levitt of KFF, Paul Fronstin of EBRI, and Ilyse Schuman of the American Advantages Council. And earlier than we go this week, we’re in search of your assistance on a undertaking right here at KFF Well being Information. Are you a younger grownup confused about navigating the exchanges used to choose plans? Have you ever purchased a plan on an ACA change and located that it didn’t cowl care you wanted? Have you ever married or taken a job simply to get insurance coverage? Did you determine to go with out protection?
No matter your story, KFF Well being Information and The New York Occasions need to hear it. E mail your expertise to Elisabeth Rosenthal — that’s elisabethr with an S, not a Z — @kff.org. As all the time, for those who benefit from the podcast, you’ll be able to subscribe wherever you get your podcasts. We’d recognize it for those who left us a overview; that helps different individuals discover us, too. Particular thanks, as typical, to our technical guru, Francis Ying, and our editor, Emmarie Huetteman. As all the time, you’ll be able to e-mail us your feedback or questions. We’re at whatthehealth, all one phrase, @kff.org, the place you’ll be able to nonetheless discover me. I’m @jrovner on X. We’ll be again in your feed subsequent week. Till then, be wholesome.
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