Listen Now

Julie Rovner

The newest faculty member at the Uniformed Services University of the Health Sciences has a great smile ― and likes to be scratched behind the ears.

Shetland, not quite 2 years old, is half-golden retriever, half-Labrador retriever. As of this fall, he is also a lieutenant commander in the Navy and a clinical instructor in the Department of Medical and Clinical Psychology at USUHS in Bethesda, Md.

The politics of health care are changing. And one of the most controversial parts of the Affordable Care Act — the so-called "Cadillac tax" — may be about to change with it.

The Cadillac tax is a 40% tax on the most generous employer-provided health insurance plans — those that cost more than $11,200 per year for an individual policy or $30,150 for family coverage. It was a tax on employers and was supposed to take effect in 2018, but Congress has delayed implementation twice.

The headlines about presidential candidate Joe Biden's new health care plan called it "a nod to the past" and "Affordable Care Act 2.0." That mostly refers to the fact that the former vice president has specifically repudiated many of his Democratic rivals' calls for a "Medicare for All" system, and instead sought to build his plan on the ACA's framework.

The fate of the Affordable Care Act is again on the line Tuesday, as a federal appeals court in New Orleans takes up a case in which a lower court judge has already ruled the massive health law unconstitutional.

State attorneys general and women's health advocates who are hoping to block in court new Trump administration rules for Title X, the federal family planning program, face one major obstacle: The Supreme Court upheld very similar rules in 1991.

Those rules were summarily canceled after a change in administrations. But the court is arguably more conservative than it was 28 years ago.

With Democrats now in control of the U.S. House of Representatives, it might appear that the fight over abortion rights has become a standoff.

After all, abortion-rights supporters within the Democratic caucus will be in a position to block the kind of curbs that Republicans advanced over the past two years when they had control of Congress.

But those on both sides of the debate insist that won't be the case.

If last Friday's district court ruling that the Affordable Care Act is unconstitutional were to be upheld, far more than the law's most high-profile provisions would be at stake.

In fact, canceling the law in full — as Judge Reed O'Connor in Fort Worth, Texas, ordered in his 55-page decision — could thrust the entire health care system into chaos.

Once again, Medicare is moving front and center in this fall's campaigns.

Throughout the election season, Democrats have been criticizing Republicans over votes and lawsuits that would eliminate insurance protections for pre-existing conditions for consumers.

But now Republicans are working to change the health care conversation with a tried-and-true technique used by both parties over the years: telling seniors their Medicare coverage may be in danger.

New York University's School of Medicine is learning that no good deed goes unpunished.

The highly ranked medical school announced with much fanfare this month that it is raising $600 million from private donors to eliminate tuition for all its students — even providing refunds to those currently enrolled. Before the announcement, annual tuition at the school was $55,018.

Senate Democrats, who are divided on abortion policy, are instead turning to health care as a rallying cry for opposition to Brett Kavanaugh, President Trump's Supreme Court nominee.

Specifically, they are sounding the alarm that confirming the conservative U.S. Court of Appeals judge could jeopardize one of the Affordable Care Act's most popular provisions — its protections for people with pre-existing health conditions.

What would the U.S. look like without Roe v. Wade, the 1973 case that legalized abortion nationwide?

That's the question now that President Trump has chosen conservative Judge Brett Kavanaugh as his nominee to replace retiring Supreme Court Justice Anthony Kennedy.

Dr. Atul Gawande, the surgeon-writer-researcher chosen to lead a joint health venture by three prominent employers who hope to bring down health costs, says his biggest goal is to help professionals "make it simpler to do the right thing" in delivering care to patients.

The Trump administration is refusing to defend key parts of the Affordable Care Act, essentially arguing that federal courts should find the health law's protections for people with pre-existing conditions unconstitutional.

The federal lawsuit hinges on the ACA's individual mandate, or the requirement to get health coverage or pay a penalty. The mandate has long been a sticking point for conservatives, who argue that the government should not be telling individuals what coverage they must have.

The Affordable Care Act very nearly failed to become law back in 2010 because of a dispute among Democrats over how to handle abortion in the bill.

Now a similar argument between Democrats and Republicans is slowing progress on a bill that could help cut soaring premiums and help stabilize the ACA.

At issue is the extent to which the Hyde Amendment — language commonly used by Congress to prohibit most federal abortion funding — should be incorporated into any new legislation affecting the health law.

A bipartisan group of senators and House members has been working since last summer toward measures to keep prices from rising out of control and undermining the individual market—the market that serves people who don't get insurance through work or through the government. Members hope to attach a package of fixes to what should be the year's final temporary spending bill, due late this month.

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