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 knowledgeable on well being coverage points, Julie is the creator of the critically praised reference e book “Well being Care Politics and Coverage A to Z,” now in its third version.
On September 2, 1974, President Gerald Ford signed into legislation the Worker Retirement Earnings Safety Act, higher referred to as ERISA. Whereas the legislation was primarily meant to control and defend employee pensions, it additionally essentially modified how medical health insurance is offered and controlled in the US. Fifty years on, ERISA performs a task in practically each element of medical health insurance and has had a profound influence on your entire 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 legislation’s previous, current, and future with three consultants on ERISA: Larry Levitt of KFF, a well being info 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: Howdy, 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 among the finest and smartest well being reporters in Washington, however right this moment, we’ve a particular episode for you. We’re taping this week on Monday, Aug. twelfth, at 2 p.m. As at all times, information occurs quick, and issues would possibly’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 possible accustomed to the large 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 Reasonably priced Care Act in 2010, simply to call just a few.
One you might not have heard as a lot about is ERISA, the Worker Retirement Earnings Safety Act, which was signed in 1974 by then-President Gerald Ford. This fall marks 50 years since ERISA grew to become legislation. ERISA, as its title suggests, is generally about defending pension advantages for staff. It was impressed, a minimum of partly, by the collapse of a pension fund when a plant that constructed Studebaker automobiles in Ohio shut down in 1963. However, a minimum of 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 thing of how well being advantages are regulated within the U.S.
I’m happy to have an all-star panel right here to affix 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 government vice chairman for coverage right here at KFF and one in every of just a few 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 suppose tank that does analysis and schooling. Paul has additionally taught me extra about ERISA over time than most likely some other single individual.
Lastly, Ilyse Schuman is senior vice chairman of the American Advantages Council, which represents giant employers and different suppliers of well being and retirement advantages by way of employer-sponsored plans. Ilyse additionally spent a number of years on Capitol Hill engaged on the Senate committee that oversees ERISA coverage. So, a variety of data 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 in the beginning. How did well being advantages wind up being coated in a legislation that was aimed toward retiree pensions?
Paul Fronstin: None of us have been right here or there on the time, so I feel something we all know is second- or third-hand info. And such as you stated, the availability was inserted on the final minute, however I feel there have been a variety of conversations about it main as much as it being inserted on the final minute. I feel a variety 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 typically in existence earlier than ERISA handed.
And clearly these plans needed some federal safety concerning what they have been doing, and the states needed extra regulation. And I’ve learn a bit of bit about this over time, 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 feel actually the panorama again in 1974, as Paul talked about, was that increasingly more 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 — a variety of them have been again in existence 50 years in the past, some weren’t — have been discovering it more and more tough to have the ability to administer their self-funded plans on a uniform foundation nationwide.
So it wasn’t within the backrooms after they have been truly 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 referred to 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 difficult.
Fronstin: Yeah. To a point, 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 properly.
Rovner: So again in 1945, when actually none of us have been within the room, Congress handed one thing referred to as the McCarran-Ferguson Act, which was supposed to make sure that states moderately than the federal authorities retained the authority to control insurance coverage. What occurred in ERISA to alter that? Ilyse, I feel you have been already type of referring to this. And what can we imply after we discuss ERISA preemption? That’s a phrase that individuals hear quite a bit and their eyes glaze over.
Schuman: Positive. Effectively, their eyes could glaze over however it actually is foundational to thousands and thousands of Individuals and their households which are coated 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 provider.”
Rovner: In order that they’re not truly 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 are finally assuming the dangers of these claims, too. And I feel the worth. So possibly — simply to step again earlier than we discuss what a preemption is — is what we discuss employers who determine to self-fund versus those who don’t. Admittedly, lots of those 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 provider. However together with that, we get the flexibleness and we get the power to design and implement well being protection that we predict meets the wants of our inhabitants. That’s enabled us to” — talking once more from self-funded employers — “to implement revolutionary 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 way of the type of varied layers of ERISA preemption, is there’s one thing referred to 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: “When 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 keep in mind studying this many, a few years in the past.
Schuman: No. Yeah. So for those who’re in legislation 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; that means that they don’t should 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 way 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 rules that states are setting up 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 understand 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 suppose you’ll flip to with an issue along with your insurance coverage?” And actually zero individuals stated the Division of Labor, which is the federal government company that truly enforces ERISA.
Rovner: However I suppose what I used to be asking about are third-party directors, which I feel 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 means 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 just’ve by no means even heard of which are administering them for a lot of employers.
Rovner: Paul, you needed 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 absolutely insured plans.
Schuman: Proper.
Fronstin: So absolutely insured plans are regulated each by ERISA and on the state stage. And you then’ve received some self-insured plans like authorities plans that aren’t coated by ERISA, proper? However they’re self-insured. So it’s much more difficult than what we’re making it out to be after we discuss ERISA, preemption, and self-insurance. That’s only one side of ERISA.
Schuman: And I feel to the purpose about staff unsure what covers them, what doesn’t cowl them. Once more, for self-funded giant employers, I imply, I feel a lot of the staff perceive from their employer, from the group well being plan, what the phrases of the plan are, and what the advantages are. And I feel in some methods, maybe much less complicated than, OK, for those who’re an worker working in Kentucky, you could have one plan. When you’re an worker working in New York, you could have one other plan. And staff speaking to one another and saying, “Hey, how come you could have that and I don’t have this?”
So I feel that the readability or the consistency is essential not only for employers who’re administering the plan, however for workers understanding what the phrases of the plans are. And in addition, two issues about type of the advantages and what’s coated. There’s a distinction between a state saying, “OK, you need to cowl this profit and should cowl it in exactly this manner” versus employers who say, “Look, it’s actually essential 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 means nationwide.”
And keep in mind, ERISA, if the federal authorities, because it has accomplished over the previous, desires to make adjustments to … which are relevant to group well being plans, it could possibly amend and has amended ERISA to try this. So the market reforms, for instance, within the Reasonably priced Care Act, have been relevant, and the Public Well being Service Act, have been type 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 will likely be relevant to self-funded plans as properly is on the federal stage.
Rovner: After I was first protecting Congress within the 19… late-Eighties and early-Nineteen Nineties, you didn’t go there. When you needed to do one thing about well being coverage, you didn’t contact ERISA. I feel lawmakers have been afraid of reopening it and entering into all types of fights. Why did that lastly change?
Levitt: I imply, I feel there was a rising recognition, significantly with the Reasonably priced Care Act, that there have been just a few minimal thresholds that well being protection needed to meet to be professional protection. So for those who take a look at what the ACA did, and as Ilyse stated, these utilized to all employers, all group well being plans by way of the amendments to ERISA.
And these have been issues like no preexisting situation exclusions, protection of preventive providers with no affected person value 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 solution to attain everybody with insurance coverage with out amending ERISA underneath the Reasonably priced 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. Effectively, there’s been a few cases of that. And definitely the Clinton well being plan tried this and didn’t succeed within the early Nineteen 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 power to proceed your insurance coverage after you permit an employer was an modification to ERISA.
Rovner: That’s proper. And that was in 1986.
Fronstin: Yeah, and even that might 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 discuss who’s not topic to ERISA as a result of I don’t suppose anyone talked about church plans. There’s a rule, after which there’s all these exceptions.
Fronstin: I feel the 2 main classes are church plans, and I’m unsure we also have a good deal with on how many individuals are coated by church plans as a result of a variety 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 coated by ERISA. I imagine that the state and native governments have their very own legislation that’s much like ERISA, however it’s not ERISA.
Schuman: And I feel after we discuss coated 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 essential protections. There are essential disclosure necessities for workers, for members which are included in there which are relevant to all ERISA plans, self-funded and insured plans, and clearly on the retirement plans, too.
However I simply suppose it’s actually essential that we glance to see the concept behind ERISA was that, sure, there will likely be this uniformity for self-funded plans. However for all ERISA plans, there are these protections and safeguards in there which are embedded within the legislation for the good thing about members.
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 kind. However that’s the place that comes from, proper? On the requirement that you just be informed the whole lot that your plan covers.
Schuman: Proper. Right.
Rovner: So, Larry, you sort 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 better 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 may’t go to your state regulatory company?
Levitt: No, there have been some adjustments to that, however enforcement of ERISA remains 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 feel it’s actually this construction of ERISA that, Julie, you stated individuals have been at all times proof against amending in Congress, that has been proof against modification, proper? I imply, this concept that states regulate insurance coverage immediately however that states can not regulate group well being plans underneath ERISA. And that’s had far-reaching well being coverage implications. So states seeking to do employer mandates or something that immediately 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 way 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 will simply step again 50 years, I feel 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 legislation’s crowning achievement.
And he stated it was the crowning achievement as a result of, with out it, the laws wouldn’t have loved the help 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 feel simply sort of getting again into the minds of the drafters of ERISA, that cut price, if you’ll, that grew to become ERISA preemption was actually foundational to the legislation passing.
Rovner: And you may see why it will make sense. When 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 feel fast-forward 50 years, and we’ve received, actually, post-pandemic or after the pandemic, an more and more cellular 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 home in one other state or to have the ability to switch from one location to a different.
So suppose a bit of bit if we simply see how the workforce itself has developed, I feel that ERISA preemption provision could turn out to be much more essential. And I feel 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 cellular, and needs to be, that increasingly more employers of multistate employers, too.
Levitt: I’d say we’ve more and more seen smaller employers self-funding, and there are some benefits to that, proper? They don’t essentially should pay premium taxes to states, and they’re exempt from state profit mandates that apply over and above past the Reasonably priced Care Act. I imply, insurers have provide you with very artistic methods of permitting smaller companies to self-fund and avoiding among the threat by layering numerous reinsurance on prime 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 received 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 doable 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 this moment with the ACA assured difficulty and backed protection, you’ll get to the purpose the place if employers didn’t have the power to offer one profit plan throughout all 50 states, they’re not going to do it anymore, proper? They’ve received … pre-ACA would possibly’ve been completely different, however now they’ve received another the place their staff may get protection in the event that they didn’t supply protection themselves.
Rovner: In order that was all predicted. This large motion away from employer-provided protection after the ACA handed was predicted, and it didn’t occur.
Fronstin: I used to be a type of individuals predicting it. Yeah. Earlier than the ACA handed, I used to be a type of individuals predicting it. And I feel 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 a very good excuse to do away with it.
We haven’t had — aside from the recession tied to covid — we haven’t had a recession. Our unemployment fee has been at traditionally low charges. And I feel 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 staff for a similar factor they have been doing again within the Forties and ’50s after they first began providing it.
Schuman: I feel it’s essential to delineate the employer voice in right here. And I feel possibly there’s a notion that employers are simply writing the checks or employers and well being plans are sort of conflated. However employers are doing much more than simply writing a verify. And I feel 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’ll attempt to drive extra reasonably priced, higher-value, higher-quality well being care.
And so it’s not nearly who writes the verify, however the causes behind employers saying, “Hey, we’re going to be spending … we spend a complete 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 quite a bit coming from the states, however there’s quite a bit coming from employers, too.
Rovner: So what are the large points going ahead for ERISA? I imply, clearly, there’s nonetheless, for those who Google ERISA, you get all types of lawsuits and challenges. And I imply, it’s nonetheless a really full of life a part of the legislation 50 years on.
Levitt: I imply, I feel, Julie, you talked about these lawsuits, and that’s probably a giant difficulty going ahead. One thing referred to 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 making an attempt to get the bottom prices, significantly for prescribed drugs. And these began out as sort of a fringe motion, however I feel pose some potential dangers for group well being plans.
Rovner: Ilyse, what are employers most involved about?
Schuman: Effectively, I feel that employers seeing the rising variety of states which are making an attempt to chip away, if not erode in a elementary means, ERISA preemption is absolutely alarming. Quite a lot of these efforts have come up round pharmacy profit managers and efforts to control pharmacy profit managers on the state stage.
However the way in which that they’ve accomplished it, the states have actually taken direct purpose at ERISA preemption and self-funded plans and, I feel, has a lot broader implications for self-funded group well being plans past simply the PBM context. And so I feel that they’re wanting on the rising variety of states which are curious about passing legal guidelines that basically erode ERISA preemption as very alarming.
Rovner: So I need to go across the desk earlier than we finish. Type of what do you suppose has been the largest influence 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 feel the largest influence of ERISA has been placing the brakes on some state well being reform efforts. States have discovered methods to get round it. Some elevate some points for employers, like Ilyse was saying, however it has actually circumscribed what states can do round well being reform. That stated, ERISA has offered a really secure regulatory setting for employers and sure allowed employer protection to develop over time in that setting.
Rovner: Paul?
Fronstin: Yeah, I’d say, along with that, it’s allowed employers to be revolutionary. Not each self-insured employer has been revolutionary, proper? And there’s one thing like 1,000,000 employers on the market with a thousand or extra staff. And the smaller of these are usually not essentially being revolutionary, however they’re studying from the biggest ones, proper? The jumbo employers, who’re making an attempt to do various things in relation to partaking the well being system, proper? Participating hospitals and physicians and pharmaceutical managers.
And I feel that that … the teachings discovered from what they’re doing trickles all the way down to the smaller self-insured employers, and it trickles out to the well being insurers which are providing absolutely insured plans to small employers.
Rovner: Ilyse.
Schuman: I feel ERISA has allowed employers to offer value-driven, complete, reasonably priced, higher-quality well being protection to working households throughout the nation — 150 million, 180 million, guess it relies upon what stats you’re , and that it’s withstood the take a look at of time.
And I feel that most likely no stressor, just like the pandemic, the place many questioned what would emerge from that, and with some dents, but additionally with a variety of silver linings by way of employers providing advantages to assist their staff navigate by way of the pandemic. And so I feel 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 can’t 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: Effectively, I’ll say that I only in the near past received 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 feel that there’s actually an essential inflection level. And I feel if addressing among the underlying drivers of rising well being care prices and consolidation, I feel that if these are addressed, I feel employer-provided protection actually has the power to resist the take a look at of time over the following 50 years.
Rovner: Good. Thanks all a lot. This has been nice.
Schuman: Thanks quite a bit.
Levitt: Nice. Thanks, Julie.
Schuman: Thank your workforce.
Levitt: Thanks all.
Schuman: Bye-bye.
Fronstin: Take care, all people.
Levitt: Bye.
Rovner: Bye. OK, that’s our ERISA anniversary present. Massive 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 select 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 Instances need to hear it. Electronic mail your expertise to Elisabeth Rosenthal — that’s elisabethr with an S, not a Z — @kff.org. As at all times, for those who benefit from the podcast, you may subscribe wherever you get your podcasts. We’d admire it for those who left us a evaluate; that helps different individuals discover us, too. Particular thanks, as ordinary, to our technical guru, Francis Ying, and our editor, Emmarie Huetteman. As at all times, you may electronic mail us your feedback or questions. We’re at whatthehealth, all one phrase, @kff.org, the place you may 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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