\t\t\t<\/p>\n
\tEmmarie Huetteman
\n\tKFF Health News<\/p>\n
\t\t\t \t\t\tEmmarie Huetteman,\u00a0senior editor, oversees a team of Washington reporters, as well as \u201cBill of the Month\u201d\u00a0and KFF Health News\u2019 \u201cWhat the Health?\u201d She previously spent more than a decade reporting on the federal government, most recently covering surprise medical bills, drug pricing reform, and other health policy debates in Washington and on the campaign trail.\u00a0\t\t<\/p>\n Recent comments from former President Donald Trump and Republican lawmakers preview potential health policy pursuits under a second Trump administration. Trump is yet again eyeing changes to the Affordable Care Act, while key lawmakers want to repeal Medicare drug price negotiations.<\/p>\n Also, this week brought news of the first publicly reported death attributed to delayed care under a state abortion ban. Vice President Kamala Harris said the death shows the consequences of Trump\u2019s actions to block abortion access.<\/p>\n This week\u2019s panelists are Emmarie Huetteman of KFF Health News, Joanne Kenen of Politico and the Johns Hopkins University\u2019s schools of nursing and public health, Tami Luhby of CNN, and Shefali Luthra of The 19th.<\/p>\n \t\t\t \tJoanne Kenen \t\t\t \t\t\t \t\t\t \tTami Luhby \t\t\t \t\t\t \t\t\t \tShefali Luthra \t\t\t \t\t\t Among the takeaways from this week\u2019s episode:<\/p>\n Plus, for \u201cextra credit,\u201d the panelists suggest health policy stories they read this week that they think you should read, too:\u00a0<\/p>\n Emmarie Huetteman:<\/strong> The Washington Post\u2019s \u201cWhat Warning Labels Could Look Like on Your Favorite Foods<\/a>,\u201d by Lauren Weber and Rachel Roubein.\u00a0<\/p>\n Shefali Luthra:<\/strong> KFF Health News\u2019 \u201cAt Catholic Hospitals, a Mission of Charity Runs Up Against High Care Costs for Patients<\/a>,\u201d by Rachana Pradhan.\u00a0<\/p>\n Tami Luhby:<\/strong> Politico Magazine\u2019s \u201cDoctors Are Leaving Conservative States To Learn To Perform Abortions. We Followed One<\/a>,\u201d by Alice Miranda Ollstein.\u00a0<\/p>\n Joanne Kenen:<\/strong> The New York Times\u2019 \u201cThis Chatbot Pulls People Away From Conspiracy Theories<\/a>,\u201d by Teddy Rosenbluth, and The Atlantic\u2019s \u201cWhen Fact-Checks Backfire<\/a>,\u201d by Jerusalem Demsas.\u00a0<\/p>\n Also mentioned on this week\u2019s podcast:<\/p>\n ProPublica\u2019s \u201cAbortion Bans Have Delayed Emergency Medical Care. In Georgia, Experts Say This Mother\u2019s Death Was Preventable<\/a>,\u201d by Kavitha Surana.<\/p>\n \t\t\t\t\tClick to Open the Transcript\t\t\t\t<\/p>\n \t\t\t\t\t\tTranscript: American Health Under Trump \u2014 Past, Present, and Future<\/strong>\t\t\t\t<\/p>\n [<\/em>Editor\u2019s note:<\/em><\/strong> This transcript was generated using both transcription software and a human\u2019s light touch. It has been edited for style and clarity.]<\/em>\u00a0<\/p>\n Emmarie Huetteman:<\/strong> Hello, and welcome back to \u201cWhat The Health?\u201d I\u2019m Emmarie Huetteman, a senior editor for KFF Health News and the regular editor on this podcast. I\u2019m filling in for Julie this week, joined by some of the best and smartest health reporters in Washington. We\u2019re taping on Thursday, September 19th, at 10 a.m. As always, news happens fast and things might\u2019ve changed by the time you hear this. So, here we go.\u00a0<\/p>\n We\u2019re joined today, by videoconference, by Tami Luhby of CNN.\u00a0<\/p>\n Tami Luhby:<\/strong> Good morning.\u00a0<\/p>\n Huetteman:<\/strong> Shefali Luthra of The 19th.\u00a0<\/p>\n Shefali Luthra:<\/strong> Hello.\u00a0<\/p>\n Huetteman:<\/strong> And Joanne Kenan of Politico and Johns Hopkins University Schools of Nursing and Public Health.\u00a0<\/p>\n Joanne Kenan:<\/strong> Hi everybody.\u00a0<\/p>\n Huetteman:<\/strong> No interview this week, so let\u2019s get right to the news, shall we? It\u2019s big, it\u2019s popular, and if Donald Trump reclaims the presidency, it could be on the chopping block again. Yes, I\u2019m talking, of course, about the Affordable Care Act. Over the weekend, Senator JD Vance claimed that Trump had \u201cprotected Americans\u201d insured under the ACA from \u201closing their health coverage.\u201d Trump himself made a similar claim during the recent debate, where he also said he has the \u201cconcepts of a plan\u201d for health reform. Vance, who is Trump\u2019s running mate, suggested the GOP could loosen regulations to make cheaper policies available. But otherwise, the Trump campaign has not said much about what his administration might change.\u00a0<\/p>\n Meanwhile, Vice President Kamala Harris has backed off her own plan to change the ACA. You may remember that when she was running for president in 2019, Harris embraced a \u201cMedicare for All\u201d plan. Now, Harris says she plans to build on the existing health system rather than replace it. So let\u2019s talk about what Trump might do as president. What sort of changes could Trump implement to make policies cheaper, as Vance has suggested?\u00a0<\/p>\n Luhby:<\/strong> Well, one of the things that Vance has talked about, when he talks about deregulating the market, giving people more choice of plans, it\u2019s actually separating people, the healthier people and the sicker enrollees, into separate, different risk pools, which is what existed before the ACA. And that may be, actually, better for the healthy people. That might lower their premiums. But it would cause a lot of problems for sicker enrollees, those with chronic health conditions or serious illnesses, because they would see their premium skyrocket. And this is one of the reasons why health care was so unaffordable for many people prior to the ACA. So Vance says that he wants to protect people with preexisting conditions. That\u2019s what everyone says. It\u2019s a very popular and well-known provision of the ACA. But by separating people into different risk pools, it would actually hurt people with preexisting conditions, because it may make their health insurance unaffordable.\u00a0<\/p>\n Kenan:<\/strong> The difference between pre-ACA and post-ACA is it might actually even be as bad or possibly worse for people with preexisting conditions. Right now, everybody\u2019s in one unified risk pool, right? Whether you\u2019re sick or healthy, your costs, more or less, get averaged out, and that\u2019s how premiums are calculated. Before ACA, people with preexisting conditions just couldn\u2019t get covered necessarily, or if they got covered, it was sky-high, the premiums. By doing what Tami just described, the people, presumably, in the riskiest pool, the sickest people, the insurers would have to offer them coverage. They couldn\u2019t say, \u201cNo, you\u2019re sick, you can\u2019t have it,\u201d because there\u2019s guaranteed coverage. But it would be sky-high. So it would be de facto no insurance for most of those people unless the government were to subsidize them to a really high extent, which I didn\u2019t hear JD Vance mention the other day.\u00a0<\/p>\n Luthra:<\/strong> Right.\u00a0<\/p>\n Luhby:<\/strong> And one of the other things that they talked about, more choice. I mean, one of the issues that a lot of people complained about in the ACA, early on, was that they didn\u2019t want substance abuse coverage. There\u2019s 10 health-essential benefits which every insurer has to cover \u2014 pregnancy, maternal care, et cetera. And 60-year-old men or even 60-year-old women said: Why am I paying for this? This is making my plan more expensive.<\/em> But again, as Joanne said, it\u2019s evening out the costs among everyone so that it\u2019s making health care more affordable for everyone. And if you allow people to start picking and choosing what benefits they want covered, it\u2019s going to make the plans more expensive for those who need the higher-cost care.\u00a0<\/p>\n Luthra:<\/strong> Tami alluded to something that is really important, which is that these conditions we\u2019re talking about are very common. A lot of people get pregnant, for example. A lot of people have chronic health conditions. We are not the healthiest country in the world. And so when you think about who would be affected by this, it\u2019s quite a large number of Americans who would no longer be able to get affordable health coverage and a small group of people who probably would. Because, I mean, one thing that\u2019s worth noting \u2014right? \u2014 is even if you are healthy for a time, that\u2019s a transient state. And you can be healthy when you are young and get older and suddenly have knee problems, and then things look very different.\u00a0<\/p>\n Huetteman:<\/strong> It seems like if they use the exact words, \u201cpreexisting-condition protections,\u201d and said they were trying to roll them back in order to make policies cheaper, that might be just a bad political move all around. Preexisting-condition protections are pretty popular, right?\u00a0<\/p>\n Luhby:<\/strong> Yes, they certainly are. But that\u2019s why they\u2019re saying they\u2019re going to continue it. But what\u2019s also popular is choice. And that\u2019s been one of the knocks against the Affordable Care Act, is that, while there are a lot of plans out there, they do have to conform to certain requirements, and therefore that gives people less choice. I mean, and remember, one of the things that we started by talking about, what a second Trump administration might look like for health care. One of the things the first Trump administration did is loosen the rules on short-term plans, which don\u2019t have to conform to the ACA. And prior, they were available for a short time as a bridge between policies, but the Trump administration lengthened them to up to three years. And the goal of the Trump administration was that people would have more choice. They could pick skinnier plans that they felt would cover them. But they didn\u2019t always realize that if they got into a car accident, if they were diagnosed with cancer, if something bad happened, they did not have all of the protections that ACA plans have.\u00a0<\/p>\n Huetteman:<\/strong> Joanne, you have something to add.\u00a0<\/p>\n Kenan:<\/strong> So the first thing is that they spent years and a lot of political capital trying and failing to repeal the ACA or to make major changes in the ACA. The reason it failed is because even then, when the ACA was sort of quasi-popular and there was a lot of controversy still, the preexisting-condition part was extremely popular. Since then, the ACA has become even more popular. What [former President Barack] Obama said when he was speaking to the Democratic National Committee convention the other night \u2014 remember that aside where he said, Hey, they don\u2019t call it Obamacare anymore now that it\u2019s popular. <\/em>It is<\/em> popular. You\u2019ve even had Republican senators going on record saying it\u2019s here to stay.<\/em>\u00a0<\/p>\n So major overhaul of it is, politically, not going to be popular. Plus, the Republicans, even if they capture the Senate, which is what most of the prognosticators are saying right now, it would be a small majority. If the Republicans have 51, 52, none of us know exactly what\u2019s going to happen, because we\u2019re in a rather rapidly changing political environment. But say the Republicans capture the Senate and say Trump is in the White House. They\u2019re not going to have 60 votes. They\u2019re not going to have anywhere near 60 votes. I\u2019m not even sure if there was a way to do this under reconciliation, which would require 51. I\u2019m not sure they have 51 votes. So and then if they do it through some kind of regulatory approach \u2014 which I think is harder to do, something this massive, but people find a way \u2014 then it ends up in court.\u00a0<\/p>\n So I think it\u2019s politically unfeasible, and I think it\u2019s practically unfeasible. I think there are smaller things they could do to weaken it. I mean, they did last time, and coverage dropped under Trump, last time. I mean, they could not promote it. They could not market it. They could not have navigators helping people. There\u2019s lots of things they could do to shrink it and damage it, but there\u2019s a difference between denting something and having a frontal collision. And we\u2019ve all seen Vance have to roll back other things that he\u2019s predicted Trump would do, so this is very TBD.\u00a0<\/p>\n Huetteman:<\/strong> One of the bigger issues with the ACA going into next year is these enhanced subsidies that Joe Biden implemented under the pandemic, that helped a lot of people pay for their premiums, will expire at the end of 2025. And depending on which party has control after this election, that could decide the fate of the subsidies. Joanne, you had something to add on this.\u00a0<\/p>\n Kenan:<\/strong> That\u2019s the big vulnerability. And it\u2019s not so much, are they going to repeal it or define their concept of a plan? I mean, the subsidies are vulnerable because they expire without action, and they\u2019re part of a larger debate that\u2019s going to happen no matter who wins the presidency and no matter who wins Congress. It\u2019s that a lot of the tax cuts expire in 2025. The subsidies are part of that tax, but many aspects of the tax bill are going to be a huge issue no matter who\u2019s in charge.\u00a0<\/p>\n The subsidies are vulnerable, right? Republicans think that they went too high. Basically those subsidies let more middle-class people with a higher income get ACA subsidies, so insurance is more affordable. And quite a few million people \u2014 Tami might remember how many, because I don\u2019t \u2014 are getting subsidized this way. It\u2019s not free. They don\u2019t get the biggest subsidies as somebody who\u2019s lower-income, but they are getting enough subsidies that we saw ACA enrollment go up. That is where the big political battle over the ACA is inevitable. I mean, that is going to happen no matter what else happens around aspects of repealing or redesigning or anything else. This is inevitable. They expire unless there\u2019s action. There will be a fight.\u00a0<\/p>\n Luhby:<\/strong> Yeah, these\u2014\u00a0<\/p>\n Kenan:<\/strong> And I don\u2019t know how it\u2019ll turn out, right?\u00a0<\/p>\n Luhby:<\/strong> These subsidies were created as part of the American Rescue Plan in 2021 and were extended for two years as part of the Inflation Reduction Act, which the Republicans don\u2019t like. And they have, as Joanne said, they\u2019ve allowed more middle-class people to come in, and also, they\u2019re more generous subsidies than in the past. Plus they\u2019ve made policies free for a lot of lower-income people. Folks can get these policies without premiums. So enrollment has skyrocketed, in large part because of these subsidies. Now there are more than 20 million people enrolled. It\u2019s a record. So the Biden administration would like to keep that intact, especially if Harris wins the presidency. But it will be a big fight in Congress next year, as part of the overall Tax Cuts and Jobs Act negotiations, and we\u2019ll see what the Democrats might have to give up in order to retain the subsidies. The\u2014\u00a0<\/p>\n Kenan:<\/strong> It\u2019s going to be, yeah.\u00a0<\/p>\n Luhby:<\/strong> Enhanced subsidies.\u00a0<\/p>\n Kenan:<\/strong> There are deals to be had with tax cuts versus subsidies, because these are large, sprawling bills with many moving parts. But it\u2019s way too early to know if Republicans are willing to deal on this and what a deal would look like. We\u2019re nowhere near there. But yeah, if you talk about ACA battles in 2025, that\u2019s number one.\u00a0<\/p>\n Huetteman:<\/strong> Well, speaking of health policies that are on the GOP agenda, some high-ranking Republican lawmakers are saying they want to repeal the Inflation Reduction Act if the party wins big in November, particularly the part that enables Medicare drug negotiations. You may recall their objections from when Congress passed the law two years ago. Republicans argue the negotiations harm innovation and amount to government price controls. But on the other hand, drug prices are an issue where Trump kind of sort of agrees with Democrats. He has promised to \u201ctake on Big Pharma.\u201d Does this mean we could see a Republican Congress fighting with Trump over drug price negotiations?\u00a0<\/p>\n Luhby:<\/strong> Well, he did have a lot of executive orders and a lot of efforts that were very un-Republican-like. One was called Most Favored Nation. He didn\u2019t say that we should do negotiations. We were just going to piggyback on the negotiations done in other countries and get their lower prices. He didn\u2019t really get very far in a lot of those measures, so it didn\u2019t come to a fight with the Republican Congress. But he may leave the negotiation process alone, the next set of drugs, that\u2019ll be 15 drugs, that, we\u2019ll find out next year, that will be negotiated. So he could leave that alone. If he tries to expand it, yeah, he may have some problems with the Republican Congress. But as we\u2019ve also seen, a Republican Congress has acquiesced to his demands in the past.\u00a0<\/p>\n Huetteman:<\/strong> And Congress certainly has no shortage of battles teed up for 2025, of course. Speaking of, here we are again. Yesterday, in the House of Representatives, Democrats and Republicans joined together to defeat a stopgap spending bill that would\u2019ve kept the government open. To be sure they didn\u2019t have the same objections, Democrats opposed a Republican amendment that would impose new voter registration requirements about proving citizenship. And hard-right Republicans objected to the size of the temporary spending bill, $1.6 trillion. Trump weighed in on social media, calling on Republicans to oppose any government spending bill at all, unless it comes with a citizenship measure.\u00a0<\/p>\n Now, Senate Republican leaders, in particular, are not thrilled about this. Here are the words of [Senate minority Leader] Mitch McConnell, who said it better than I can: \u201cIt would be politically beyond stupid for us to do that right before the election, because certainly, we\u2019d get the blame\u201d for that government shutdown. What happens now?\u00a0<\/p>\n Kenan:<\/strong> Last-minute agreement, like, I feel. I used to cover the Hill full time. I no longer do, but it was, like, late nights standing in the hallway for a last-minute reprieve. At some point, they\u2019re going to probably keep the government open, but with Trump\u2019s demands and the citizenship proof of a life for voters and all that, it\u2019s going to be really messy. Mike Johnson became speaker after a whole bunch of other speakers failed to keep the government open.\u00a0<\/p>\n Huetteman:<\/strong> That\u2019s right.\u00a0<\/p>\n Kenan:<\/strong> Probation spell, we went through chaos, he has a small majority. He survived because the Democrats intervened on his behalf once, because of Ukraine. We have no idea the dynamics of \u2014 do the Democrats want to see complete chaos so the Republicans get blamed? Who knows? I don\u2019t think it\u2019s going to be a handshake tomorrow and Let\u2019s do a deal<\/em>. What they usually do is continue current spending levels and what they call a continuing resolution. So you keep status quo for one month, two months, three months, sometimes 10 months. The odds are, the government will stay open at some kind of a last-minute patchwork deal that nobody particularly likes, but that\u2019s likely. I wouldn\u2019t say that certain. Republicans have backed off shutting the government down for a while now, a couple of years.\u00a0<\/p>\n Huetteman:<\/strong> It\u2019s worth noting, though, that even this bill that they just voted down would\u2019ve only kicked the can down to March. So we are still talking about something that the new Congress would have to deal with pretty quickly, even if we can get something done short-term. But we\u2019ve got a lot of news today. So moving on to reproductive health news.\u00a0<\/p>\n This week, Senate Republicans, again, blocked a bill that would\u2019ve guaranteed access to in vitro fertilization nationwide. That federal bill would, of course, have overridden state laws that restrict access to the procedure. You may recall that Republicans also blocked that bill earlier this summer, describing it as a political show vote. And indeed, Democrats are<\/em> trying to get Republicans on the record, opposing IVF, in order to draw contrast with the GOP before voters go to the polls. What do we think? Did Democrats succeed here in showing voters their lawmakers really think about IVF?\u00a0<\/p>\n Luthra:<\/strong> I mean, realistically, yes, I think this is a very effective strategy for Democrats. If they could talk about abortion and IVF every day, all day, they would. We can look at Taylor Swift\u2019s endorsement of Kamala Harris and [Minnesota Gov.] Tim Walz. She specifically mentions reproductive rights, and she mentions IVF in particular, noting that she thinks that these are the candidates who will support access to that fertility regimen. IVF is very popular, and it is obviously going to be a major battle, because it is the next frontier for the anti-abortion movement, and the Republican Party is allied very closely to this movement. Even if there have been more fractures emerging lately, I just don\u2019t see how Republicans can find a way to make this a political winner for them, unless they figure out a way to change their tune, at least temporarily, without alienating that ally they have.\u00a0<\/p>\n Huetteman:<\/strong> Absolutely. And meanwhile, speaking of the consequences of these actions on abortion lately, this week we learned of the first publicly reported death from delayed care under a state abortion ban. ProPublica reported<\/a> the heart-wrenching story of a 28-year-old mother in Georgia who died in 2022 after her doctors held off on performing a D&C [dilation and curettage procedure]. Performing a D&C in Georgia is a felony, with a few exceptions. Sorry, this is difficult to talk about, especially if you or someone you know has needed a D&C, and that may be a lot of us, whether we know it or not.\u00a0<\/p>\n Her name was Amber Thurman. Amber needed the D&C because she was suffering from a rare complication after taking the abortion pill. She developed a serious infection, and she died on the operating table. Georgia\u2019s Maternal Mortality Review Committee determined that Amber Thurman\u2019s death was preventable. ProPublica says at least one other woman has died from being unable to access illegal abortions and timely medical care. And as the story said, \u201cThere are almost certainly others.\u201d On Tuesday, Vice President Harris said Amber\u2019s death shows the consequences of Trump\u2019s actions to block abortion access. How does this affect the national conversation about abortion? Does it change anything?\u00a0<\/p>\n Luthra:<\/strong> I mean, it should, and I don\u2019t think it\u2019s that simple. And it\u2019s tough, because, I mean, these stories are incredible pieces of journalism, and what they show us are that two women are dead because of abortion bans \u2014 and that there are almost certainly many more, because these deaths were in 2022, very soon after the Dobbs<\/em> decision. And what has been really striking, at the same time, is that the anti-abortion movement has very clear talking points on these deaths. And they\u2019re doing what we have seen them do, in so many cases, where women have almost lost their lives, and now, in these cases where they have, which is they blame the doctors. And they have been going out of their way to argue that, actually, the exceptions that exist in these laws are very clear, even though doctor after doctor will tell you they are not, and that it is the doctor\u2019s fault for not providing care when there is very obviously an exception.\u00a0<\/p>\n They are also arguing that this is further proof that medication abortion, which is responsible for the vast majority of abortions in this country, is unsafe, even though, as you noted and as these stories noted, the complications these women experienced are very rare and could be addressed and treated for and do not have to be fatal if you have access to health care and doctors who are not handcuffed by your state\u2019s abortion laws. And so what I think happens then is this is something that should matter and that should change our conversation. And there are people talking about this and making clear that this is because of the reproductive health world that we live in, but I don\u2019t think it will necessarily change the course of where we are headed, despite the fact that what abortion opponents are saying is not true and despite the fact that these abortion bans remain very unpopular.\u00a0<\/p>\n Kenan:<\/strong> I think you can, and she said it really well, but I think in terms of, does it change minds? Think about the two bumper stickers, right? One is \u201cAbortion bans kill,\u201d and the other one is \u201cThe abortion pill kills.\u201d And both of these women had medication abortions. Those side effects are very, very, very unusual, that dangerous side effects, are extremely unusual. There\u2019s years of data, there\u2019s like no drug on Earth that is a hundred percent, a thousand percent, a hundred thousand percent safe. So these were tragedies in which the women did develop severe life-threatening side effects, didn\u2019t get the proper treatment. But think about your bumper stickers. I don\u2019t think this changes a lot of minds.\u00a0<\/p>\n Huetteman:<\/strong> All right. Well, unfortunately we will keep watching for this and more news on this subject. But in state news, Nevada will become the 18th state to use its Medicaid funds to cover abortions after a recent court ruling. While federal funds are generally barred from paying for abortions, states do have more flexibility to use their own Medicaid funds to cover the procedure. And, North Dakota\u2019s abortion ban has been overturned, after a judge ruled that the state\u2019s constitution protects a woman\u2019s right to an abortion until the fetus is viable. But there\u2019s a bigger challenge: The state has no abortion clinics left. We\u2019ve talked a lot on this podcast about how overturning Roe<\/em> has effectively created new, largely geographical classes of haves and have-nots, people who can access abortion care and people who can\u2019t. It seems like the lesson out of North Dakota right now is that evening that playing field isn\u2019t as simple as changing the law, yes?\u00a0<\/p>\n Luthra:<\/strong> Absolutely. And this is something that we have seen even before Roe<\/em> was overturned. I mean, an example that I think about a lot is Texas, which had had this very big abortion law passed in 2013, and it was litigated in the courts, was in and out of effect before it went to the Supreme Court and was largely struck down. But clinics closed in the meantime. And what that tells us is that when clinics close, they largely don\u2019t reopen. It is very, very hard to open an abortion clinic. It is expensive. It can be dangerous because of harassment. You need to find providers. You need to build up a medical infrastructure that doesn\u2019t exist. And we are seeing several states with ballot measures to try to undo abortion bans in their states \u2014 Florida, Missouri, Nebraska with their 12-week ban. We are seeing efforts across the country to try and restore access to these states.\u00a0<\/p>\n But the question is exactly what you pointed out, which is there is a right in name and there is a right in practice. And for all the difficulties of creating a right in name, creating a right in practice is even harder. And there is just so much more that we will need to be following as journalists, and also as people who consume health care, to fully see what it takes for people to be able to get reproductive health care, including abortion, after they have lost it.\u00a0<\/p>\n Huetteman:<\/strong> All right. And with fewer than 50 days left until Election Day and way fewer before early voting begins, a court in Nebraska has ruled that competing abortion rights measures can appear on the ballot there this fall. Two measures, one that would expand access and one that would restrict it, qualified for the ballot. Nebraska will be the first state to ask residents to vote on two opposing abortion ballot measures. Currently, the state bans abortion in most cases, starting at 12 weeks. There are at least nine other states with ballot measures to protect abortion rights this fall, but this one\u2019s pretty unusual. What do we think? Will this be confusing to Nebraska voters?\u00a0<\/p>\n Luthra:<\/strong> I mean, I imagine if I were a voter, I would be confused. Most people don\u2019t follow the ins and outs of what\u2019s on their ballot until you get close to Election Day and you are bombarded with advertisements. And I think this is really striking, because it is just part of, I guess, maybe not long, because this only happened two years ago, but part of a repeated pattern of abortion opponents trying to find different ways to get around the fact that ballot measures restoring abortion rights or protecting abortion rights largely win. And so how do you find a way around that? You can try and create confusion. You can try and raise the threshold for approval like they tried and failed to do in Ohio. You can, maybe in Nebraska this is more effective, put multiple measures on the ballot. You can try, as they tried and failed to do in Missouri, try and stop something from appearing on the ballot.\u00a0<\/p>\n And I think this is just something that we need to watch and see. Is this the thing that finally sticks? Does this finally undercut efforts to use direct voting to restore abortion rights? Which we should also note is a strategy with an expiration date of sorts, because not every state allows for this direct democracy approach. And we\u2019re actually hitting the end of the list of states very soon where this is a viable strategy.\u00a0<\/p>\n Huetteman:<\/strong> And as we know, every state where a ballot measure has addressed this issue since Roe<\/em> was overturned has fallen on the side of abortion rights, ultimately. It\u2019ll be curious to see what happens here, where voters have both choices right before them.\u00a0<\/p>\n Well, let\u2019s wrap up with tech news this week. Are you wearing an Apple Watch right now? Or maybe you\u2019re listening to us on AirPods? Well, that watch could soon tell you if you might have sleep apnea. Or, if you have trouble hearing, those earbuds could soon help you hear better. The FDA has given separate green lights to two new Apple product functions. One is an Apple Watch change that assesses the wearer\u2019s risk of sleep apnea. And the FDA also authorized Apple AirPods as the first over-the-counter hearing-aid software, to assist those with mild to moderate hearing loss. Hearing aids can be pretty expensive, and some resist wearing them due to stigma or stubbornness. What does this mean for people with these conditions, and also about the possibilities for health tech?\u00a0<\/p>\n Kenan:<\/strong> I mean, none of us are covering the FDA\u2019s tech division full time or even much at all. So basically there\u2019s been a trend toward sort of overlap with consumer and health products. Many of us have something on our wrists or something in our phone that is monitoring something or other, and there\u2019s been some controversy about how accurate some of them are. My understanding with the sleep apnea thing, that it doesn\u2019t actually diagnose it. It tracks your sleep patterns, and if it sees some red flags, it says: You might have sleep apnea. You should go see a doctor.<\/em> That\u2019s what I think that does.\u00a0<\/p>\n Huetteman:<\/strong> That\u2019s right.\u00a0<\/p>\n Kenan:<\/strong> You\u2019re asleep when you\u2019re having sleep apnea. You don\u2019t necessarily know what\u2019s happening. So it\u2019s arguably a useful thing that you have kind of an alert system. The hearing aids, it\u2019s not just these. The FDA, a few months ago, authorized more over-the-counter hearing aids of various types, which have made them much cheaper and much more accessible. This is an advance, another category, another type to have people wearing earbuds anyway. I know people who have the over-the-counter hearing aids, and they are small and cheap, so that industry has really been disrupted by tech. So we are seeing not necessarily some of the sky-in-the-pie promises of health and tech from a few years ago but some useful things for consumers to either make things more accessible or affordable, like the earbuds \u2014 although I would lose them \u2014 or just a useful tool or a potentially useful tool, I don\u2019t know how great the data is, saying ask your doctor about this. Sleep apnea is dangerous.\u00a0<\/p>\n So my mom is about to turn 90, and we have a fall monitor on her watch that we actually pay for, an extra service, that they alert emergency. I was with her once when she fell. They called her and said, Are you okay?<\/em> And she said, Yes, my daughter\u2019s here<\/em> and et cetera. Except, at 90, she still plays pingpong, doubles pingpong, not a lot of movement for 90 year olds, and it does get the fall monitor very confused. I think it\u2019s been trained. So yeah, I mean, it\u2019s not that expensive, and it\u2019s great peace of mind. People would much rather have it on their watch, because young cool people wear smartwatches, than those buttons around their neck. I would\u2019ve never gotten my mother to wear a button around her neck. So it\u2019s part of a larger trend of tech becoming a health tool, and it\u2019s not a panacea, but the affordability for over-the-counter hearing aids is a big deal.\u00a0<\/p>\n Huetteman:<\/strong> Right, right. This is expanded access. If you\u2019ve got this consumer product already in your pocket, on your wrist, in your ears, why not have it help with your health? We\u2019ve already kind of adjusted, in many ways, to health tech. We had Fitbits. We\u2019ve had things that have tracked our heart rates and that sort of thing, or even our phones can do that at this point. But hearing aids, in many cases for people who have mild or moderate hearing loss, they don\u2019t even go for a hearing aid, because they don\u2019t want to be stigmatized as being maybe a little older and being unable to hear, even if they might just muddle through. But if you\u2019ve already got those AirPods in, because you\u2019re going to take a call later, I mean, that\u2019s pretty below the radar. You don\u2019t have to feel too self-conscious about that one, so \u2026\u00a0<\/p>\n Kenan:<\/strong> Yeah, my mom would look cool, but she actually doesn\u2019t need them, so that\u2019s OK.\u00a0<\/p>\n Huetteman:<\/strong> If she\u2019s playing pingpong at her age, she already looks cool.\u00a0<\/p>\n Kenan:<\/strong> She plays pingpong very slowly. I hope I\u2019m doing the equivalent when I\u2019m 90. I hope I\u2019m 90, you know?\u00a0<\/p>\n Huetteman:<\/strong> Hear, hear.\u00a0<\/p>\n Kenan:<\/strong> You know.\u00a0<\/p>\n Huetteman:<\/strong> OK, that\u2019s this week\u2019s news. Now it\u2019s time for our extra credit segment. That\u2019s when we each recommend a story we read this week that we think you should read, too. As always, don\u2019t worry if you miss it. We\u2019ll post the links in the podcast page at kffhealthnews.org and in our show notes, on your phone or other mobile device. Shefali, why don\u2019t you go first this week?\u00a0<\/p>\n Luthra:<\/strong> All right. My story is from KFF Health News by the great Rachana Pradhan. The headline is, \u201cAt Catholic Hospitals, a Mission of Charity Runs Up Against High Care Costs for Patients.<\/a>\u201d The story is one of my favorite genres of stories, which is stories about how everyone loves their hospital and their hospital is a business. And Rachana does a great job looking at the history of Catholic hospitals and the extent to which they were founded as these beacons of charitable care meant to improve the community. But actually, when you look at where Catholic hospitals are now \u2014 and Catholic hospitals have really proliferated in the past several years \u2014 they look a lot like businesses and a lot less like charities. There\u2019s some fascinating patient stories and also analyses in here, showing that Catholic hospitals are less likely than other nonprofit hospitals to treat Medicaid patients. They are great at going after patients for unpaid medical bills, including suing them, garnishing wages, reporting them to credit bureaus. It\u2019s really great. It\u2019s the exact kind of journalism that I think we need more of, and I love this story, and I hope others do, too.\u00a0<\/p>\n Huetteman:<\/strong> Excellent. It is a great piece of journalism. We hope everyone will take some time to read it. Tami, why don\u2019t you go?\u00a0<\/p>\n Luhby:<\/strong> OK. My extra credit is an in-depth piece by one of our very own, Alice Miranda Ollstein of Politico, and it\u2019s titled, \u201cDoctors Are Leaving Conservative States to Perform Abortions. We Followed One.<\/a>\u201d So Alice followed a doctor who spent a month in Delaware learning how to perform abortions, because she couldn\u2019t obtain that training in her home state, across the country. Alice notes that Politico granted the doctor anonymity due to her fear of professional repercussions and the threat of physical violence for seeking abortion training, which is concerning to hear. While many stories have written about states\u2019 abortion bans, Alice\u2019s piece provides a different perspective. She writes about the lengths the doctors must go to obtain training in the procedure and the negative effects that the overturning of Roe<\/em> has had on medical education.\u00a0<\/p>\n The doctor she profiled spent nearly two years searching for a position where she could obtain this training, before landing at Delaware\u2019s Planned Parenthood. It cost nearly $8,000. The doctor had to pull together grants and scholarships in order to cover the costs. Alice walked readers through the doctor\u2019s training in both surgical and medical abortions and through her ethical and medical thoughts after seeing \u2014 and this is one thing that stuck with me in the story \u2014 what\u2019s called the \u201cproducts of conception\u201d on a little tray. So the story is very moving, and it\u2019s well worth your time.\u00a0<\/p>\n Huetteman:<\/strong> Absolutely. And the more detail we can get about what these sorts of procedures and this training looks like for doctors, the better we understand what we\u2019re actually talking about when we\u2019re talking about these abortion bans and other restrictions on reproductive health. Joanne, why don\u2019t you talk to us about your extra credit this week?\u00a0<\/p>\n Luthra:<\/strong> OK. There\u2019s a piece in the New York Times by Teddy Rosenbluth called \u201cThis Chatbot Pulls People Away from Conspiracy Theories.<\/a>\u201d And there\u2019s also a related podcast at the Atlantic called, by Jerusalem Demsas, \u201cWhen Fact-Checks Backfire.<\/a>\u201d They\u2019re both about the same piece of research that appeared in Science<\/a>. Basically, debunking, or fact-checking, has not really worked very well in pulling people away from misinformation and conspiracy theories. There had been some research suggesting that if you try to debunk something, it was the backfire effect, that you actually made it stick more. That doesn\u2019t always happen. There\u2019s sort of some people that it does and some people it doesn\u2019t \u2014 that\u2019s beginning to be understood more.\u00a0<\/p>\n And what this study, the Times reported on and the Atlantic podcast discussed, is using AI, because we all think that AI is going to be generating more disinformation, but AI is also going to be fighting disinformation. And this is an example of it, where the people in this study had a dialogue, a written, typed-in dialogue, where the chatbot that gave a bespoke response to conspiracy beliefs, including vaccines and other public health things. And that these individually tailored, back-and-forth dialogue, with an AI bot, actually made about 20% of the people, which is, in this field, a lot, drop their or modify their beliefs or drop their conspiracy beliefs. And that it stuck. It wasn\u2019t just because some of these fact-checks work for like a week or two. These, they checked in with people two months later and the changes in their thinking had stuck. So it\u2019s not a solution to disinformation and conspiracy belief, but it is a fairly significant arrow to new techniques and more research to how to debunk it better without a backfire effect.\u00a0<\/p>\n Huetteman:<\/strong> That\u2019s great. Thanks for sharing those. All right. My extra credit this week comes from two of our podcast pals at The Washington Post, Lauren Weber and Rachel Roubein. The headline is, \u201cWhat Warning Labels Could Look Like on Your Favorite Foods.<\/a>\u201d They report that the FDA is considering labeling food to identify when they have a high saturated fat content, sodium, sugar, those sorts of things that we should all be paying attention to on nutrition labels. But their proposal falls short, critics say. It\u2019s not quite as good, they say, at identifying the health risk factors of certain amounts of sodium and sugar in our food, especially compared to other countries.\u00a0<\/p>\n They do an extensive study on Chile\u2019s food labeling, in fact. And if you\u2019re like me and you buy a lot of your groceries for your household and you try to look at the nutrition labels, you might be surprised by some of the items the article identifies as being particularly high in sodium, like Cheerios. Bad news for my family this morning.\u00a0<\/p>\n All right, that\u2019s our show for this week. As always, if you enjoy the podcast, you can subscribe wherever you get your podcasts. We\u2019d appreciate it if you left a review. That helps other people find us, too. Special thanks, as always, to our amazing engineer, Francis Ying. And as always, you can email us your comments or questions. We\u2019re at whatthehealth@kff.org. Or you could try tweeting me. I\u2019m lurking on X, @emmarieDC<\/a>. Shefali.\u00a0<\/p>\n Luthra:<\/strong> I\u2019m @shefalil<\/a>.\u00a0<\/p>\n Huetteman:<\/strong> Joanne.\u00a0<\/p>\n Kenan:<\/strong> @JoanneKenen<\/a> on Twitter, @joanneKenen1<\/a> on Threads.\u00a0<\/p>\n Huetteman:<\/strong> And Tami.\u00a0<\/p>\n Luhby:<\/strong> Best place to find me is cnn.com<\/a>.\u00a0<\/p>\n Huetteman:<\/strong> We\u2019ll be back in your feed next week. Until then, be healthy.\u00a0<\/p>\n \tFrancis Ying \tStephanie Stapleton To hear all our podcasts,\u00a0click here<\/a>.<\/em><\/p>\n And subscribe to KFF Health News\u2019 \u201cWhat the Health?\u201d on\u00a0Spotify<\/a>,\u00a0Apple Podcasts<\/a>,\u00a0Pocket Casts<\/a>, or wherever you listen to podcasts.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n
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