The Drip, Drip, Drip of Declining Coverage

When Congress failed to extend the covid-era enhanced subsidies for the Affordable Care Act, many experts predicted millions of people would lose coverage because they would be unable to make payments toward the higher premiums. It has taken a few months, but that prediction seems to be coming true.

Meanwhile, controversy in the medical community about how — or whether  — to work with the Trump administration burst into the open at the annual meeting of the American Diabetes Association, as members who were handing out an editorial criticizing the administration’s cuts to biomedical research were evicted from the event, prompting a backlash.

This week’s panelists are Julie Rovner of KFF Health News, Lizzy Lawrence of Stat, Sandhya Raman of Bloomberg Law, and Lauren Weber of The Washington Post.

Among the takeaways from this week’s episode:

A new report from The Commonwealth Fund highlights enrollment declines in Affordable Care Act marketplaces, a trend experts predicted when Congress did not renew the enhanced ACA tax credits at the end of 2025. As consumers continue to struggle with rising costs for groceries, gas, and other expenses, individuals who lost that additional financial assistance to purchase health insurance may be facing higher premium costs and more out-of-pocket expenses.

Concerns over the difficulty of implementing the administration’s Medicaid work requirements, along with potential legal challenges, may mean the regulations could be delayed or even reversed. For example, doctor and patient groups contend that the requirement that physicians determine whether each individual can work the required 80 hours per month will create unintended consequences, such as paperwork and bureaucratic hassles, for patients and their doctors, rather than decrease fraud in the program.

On Capitol Hill, fewer days in session and more days on the midterm campaign trail, plus a lack of bipartisanship, likely mean that lawmakers may be less willing to find a path forward to strengthen the financial solvency of the Medicare and Social Security trust funds. The programs’ annual trustees’ report released this week found that the two entitlement programs, which provide benefits to millions of people, will technically become insolvent in 2033. In recent years, lawmakers have been inclined to act only when facing an imminent deadline rather than taking action to avoid a future problem.

Leaders of the American Diabetes Association apologized for having security escort several doctors and researchers, including the editor-in-chief of the association’s flagship medical journal and a past president of the ADA, from the group’s annual research meeting for distributing a journal editorial criticizing the administration’s cuts to biomedical research. The incident highlighted how fearful some nonprofit leaders are of taking on the Trump administration.

Also this week, Rovner interviews KFF’s Tricia Neuman, who is retiring this month as a senior vice president and the executive director of the Program on Medicare Policy. 

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Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too:

Julie Rovner: KFF Health News’ “Anguished Parents. Doctors in Tears. Utah’s Long Measles Outbreak Takes a Toll,” by Amy Maxmen.

Sandhya Raman: CIDRAP’s “Two Sisters, One Virus: A Family Devastated by HPV,” by Liz Szabo.

Lizzy Lawrence: The Chicago Tribune’s “One Plastic Surgeon. Eight Women Dead,” by Christy Gutowski and Gregory Royal Pratt.

Lauren Weber: ProPublica’s “The Milkman,” by Annie Waldman.

Also mentioned in this week’s podcast:

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