{"id":2105272,"date":"2025-10-30T15:00:00","date_gmt":"2025-10-30T19:00:00","guid":{"rendered":"https:\/\/kffhealthnews.org\/?p=2105272&#038;post_type=podcast&#038;preview_id=2105272"},"modified":"2025-11-03T15:49:17","modified_gmt":"2025-11-03T20:49:17","slug":"what-the-health-420-open-enrollment-obamacare-aca-shutdown-october-30-2025","status":"publish","type":"podcast","link":"https:\/\/kffhealthnews.org\/news\/podcast\/what-the-health-420-open-enrollment-obamacare-aca-shutdown-october-30-2025\/","title":{"rendered":"What the Health? From KFF Health News: Happy Open Enrollment Eve!"},"content":{"rendered":"\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\"><div class=\"block--iframe\">\n\t<iframe\n\t\tallow=\"fullscreen\"\n\t\tframeborder=\"0\"\n\t\theight=\"180\"\n\t\tsrc=\"https:\/\/play.prx.org\/e?ge=prx_14448_5b0af271-4d04-43a9-8ae4-7afd0442d6da&#038;uf=https%3A%2F%2Fwhatthehealth.feeds.wamu.org\"\n\t\twidth=\"100%\"\n\t><\/iframe>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people block--people\">\n\t\t<h3 class=\"people-title\">\n\t\tThe Host\t<\/h3>\n\t\t<div class=\"people-card-container single\">\n\t\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg 1100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/07\/Rovner-Julie2021_1100sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Julie Rovner<\/div>\n\t<div class=\"author-affiliation\">KFF Health News<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/jrovner\" title=\"@jrovner\">\n\t\t\t\t@jrovner\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/julierovner.bsky.social\" title=\"@julierovner.bsky.social\">\n\t\t\t\t@julierovner.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"https:\/\/kffhealthnews.org\/news\/author\/julie-rovner\/\"> \n\t\t\t\tRead Julie&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\tJulie Rovner is chief Washington correspondent and host of KFF Health News\u2019 weekly health policy news podcast, &quot;What the Health?&quot; A noted expert on health policy issues, Julie is the author of the critically praised reference book &quot;Health Care Politics and Policy A to Z,&quot; now in its third edition.\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n\n<p>Open enrollment for 2026 Affordable Care Act insurance plans starts in most states Nov. 1, with no resolution in Congress about whether to continue more generous premium tax credits expanded under President Joe Biden or let them expire at the end of this year. It is unclear whether the backlash from millions of enrollees seeing skyrocketing premiums will move Democrats or Republicans to back away from entrenched positions that are keeping most of the federal government shut down.<\/p>\n\n\n\n<p>Meanwhile, the Trump administration \u2014 having done away earlier this year with a Biden-era regulation that prevented medical debt from being included on consumers\u2019 credit reports \u2014 is now telling states they cannot pass their own laws to bar the practice.<\/p>\n\n\n\n<p>This week\u2019s panelists are Julie Rovner of KFF Health News, Paige Winfield Cunningham of The Washington Post, Maya Goldman of Axios, and Alice Miranda Ollstein of Politico.<\/p>\n\n\n\n<div class=\"wp-block-people block--people\">\n\t\t<h3 class=\"people-title\">\n\t\tPanelists\t<\/h3>\n\t\t<div class=\"people-card-container threewide\">\n\t\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg 1100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/10\/winfield-cunningham2025_1100sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Paige Winfield Cunningham<\/div>\n\t<div class=\"author-affiliation\">The Washington Post<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/pw_cunningham\" title=\"@pw_cunningham\">\n\t\t\t\t@pw_cunningham\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"\"> \n\t\t\t\tRead Paige&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg 800w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/02\/Goldman-Maya_800sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Maya Goldman<\/div>\n\t<div class=\"author-affiliation\">Axios<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/mayagoldman_\" title=\"@mayagoldman_\">\n\t\t\t\t@mayagoldman_\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/maya-goldman.bsky.social\" title=\"@maya-goldman.bsky.social\">\n\t\t\t\t@maya-goldman.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"https:\/\/www.axios.com\/authors\/mgoldman\"> \n\t\t\t\tRead Maya&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t\t<div class=\"author-image-container\">\n\t\t\t<img srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg 800w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=150,150 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=500,500 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=768,768 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=480,480 480w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=100,100 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=120,120 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=170,170 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=300,300 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=315,315 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/01\/Ollstein_800sq.jpg?resize=630,630 630w\" sizes=\"(max-width: 767px) 100vw, 500px\" \/>\n\t\t<\/div>\n\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Alice Miranda Ollstein<\/div>\n\t<div class=\"author-affiliation\">Politico<\/div>\n\t\t\t<div class=\"author-x\">\n\t\t\t<a class=\"icon-x author-link\" href=\"https:\/\/twitter.com\/AliceOllstein\" title=\"@AliceOllstein\">\n\t\t\t\t@AliceOllstein\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<div class=\"author-bluesky\">\n\t\t\t<a class=\"icon-bluesky author-link\" href=\"https:\/\/bsky.app\/profile\/alicemiranda.bsky.social\" title=\"@alicemiranda.bsky.social\">\n\t\t\t\t@alicemiranda.bsky.social\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"author-stories-link\">\n\t\t\t<a class=\"author-link\" href=\"https:\/\/www.politico.com\/staff\/alice-miranda-ollstein\"> \n\t\t\t\tRead Alice&#039;s stories.\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n\n<p>Among the takeaways from this week\u2019s episode:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Tens of millions of Americans are bracing to lose government food aid on Nov. 1, after the Trump administration opted not to continue funding the Supplemental Nutrition Assistance Program during the shutdown. President Donald Trump and senior officials have made no secret of efforts to penalize government programs they see as Democratic priorities, to exert political pressure as the stalemate continues on Capitol Hill.<\/li>\n\n\n\n<li>People beginning to shop for next year\u2019s plans on the ACA marketplaces are experiencing sticker shock due to the expiration of more generous premium tax credits that were expanded during the covid pandemic. The federal government will also take a particular hit as it covers growing costs for lower-income customers who will continue to receive assistance regardless of a deal in Congress.<\/li>\n\n\n\n<li>In state news, after killing a Biden-era rule to block medical debt from credit reports, the Trump administration is working to prevent states from passing their own protections. In Florida, doctors who support vaccine efforts are being muffled, and the state\u2019s surgeon general says he did not model the outcomes of ending childhood vaccination mandates before pursuing the policy \u2014 a risky proposition as public health experts caution that recent measles outbreaks are a canary in the coal mine for vaccine-preventable illnesses.<\/li>\n\n\n\n<li>And in Texas, the state\u2019s attorney general, who is also running for the U.S. Senate as a Republican, is suing the maker of Tylenol, claiming the company tried to dodge liability for the medication\u2019s unproven ties to autism. The lawsuit is the latest problem for Tylenol, with recent allegations undermining confidence in the common painkiller, the only one recommended for pregnant women to reduce potentially dangerous fevers and relieve pain.<\/li>\n<\/ul>\n\n\n<div\n\tclass=\"wp-block block--newsletter  \"\n\tdata-type=\"kaiser-health-news\/newsletter\"\n\tdata-align=\"center\"\n\tstyle=\"\"\n>\n\t<h4 class=\"newsletter__title\">\n\t\t<a href=\"\/email\/\">\n\t\t\tEmail Sign-Up\t\t<\/a>\n\t<\/h4>\n\t<p class=\"newsletter__description\">\n\t\tSubscribe to KFF Health News&#039; free Morning Briefing.\t<\/p>\n\t\n<form\n\taction=\"\/email-signup\/\"\n\tclass=\"kaiser-hubspot-mini-signup-form\"\n\tmethod=\"post\"\n>\n\t<input type=\"hidden\" id=\"kaiser_hubspot_nonce\" name=\"kaiser_hubspot_nonce\" value=\"dc9818bd64\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/podcast\/2105272\" \/>\t\t\t\t<label\n\t\tclass=\"kaiser-hubspot-mini-signup-form__label--email\"\n\t\tfor=\"kaiser-hubspot-mini-signup-form-email\"\n\t>\n\t\t<span class=\"screen-reader-text\">\n\t\t\tYour Email Address\t\t<\/span>\n\t\t<input\n\t\t\tautocomplete=\"email\"\n\t\t\tclass=\"kaiser-hubspot-mini-signup-form__input--email\"\n\t\t\tid=\"kaiser-hubspot-mini-signup-form-email\"\n\t\t\tname=\"kaiser_hubspot_email\"\n\t\t\ttype=\"email\"\n\t\t\t\t\t\t\tplaceholder=\"Your email address\"\n\t\t\t\t\t\/>\n\t<\/label>\n\t<button class=\"kaiser-hubspot-mini-signup-form__submit\">\n\t\tSign Up\t<\/button>\n<\/form>\n<\/div>\n\n\n\n<p>Plus, for \u201cextra credit\u201d the panelists suggest health policy stories they read this week that they think you should read, too:&nbsp;<\/p>\n\n\n\n<p><strong>Julie Rovner:<\/strong> KFF Health News\u2019 \u201c<a href=\"https:\/\/kffhealthnews.org\/news\/article\/medical-school-federal-loan-caps-doctor-shortage-trump-law\/\">Many Fear Federal Loan Caps Will Deter Aspiring Doctors and Worsen MD Shortage<\/a>,\u201d by Bernard J. Wolfson.<\/p>\n\n\n\n<p><strong>Alice Miranda Ollstein:<\/strong> ProPublica\u2019s \u201c<a href=\"https:\/\/www.propublica.org\/article\/veterans-affairs-male-breast-cancer-coverage-trump-executive-order\">Citing Trump Order on \u2018Biological Truth,\u2019 VA Makes It Harder for Male Veterans With Breast Cancer To Get Coverage<\/a>,\u201d by Eric Umansky.<\/p>\n\n\n\n<p><strong>Paige Winfield Cunningham:<\/strong> The Washington Post\u2019s \u201c<a href=\"https:\/\/www.washingtonpost.com\/science\/2025\/10\/23\/vaccine-cancer-covid-19-mrna\/?utm_campaign=wp_main&amp;utm_source=twitter&amp;utm_medium=social\">Study Finds mRNA Coronavirus Vaccines Prolonged Life of Cancer Patients<\/a>,\u201d by Mark Johnson.<\/p>\n\n\n\n<p><strong>Maya Goldman:<\/strong> KFF Health News\u2019 \u201c<a href=\"https:\/\/kffhealthnews.org\/news\/article\/sports-betting-state-regulation-gambling-addiciton-massachusetts\/\">As Sports Betting Explodes, States Try To Set Limits To Stop Gambling Addiction<\/a>,\u201d by Karen Brown, New England Public Media.<\/p>\n\n\n\n<p>Also mentioned in this week\u2019s podcast:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The Washington Post\u2019s \u201c<a href=\"https:\/\/www.washingtonpost.com\/health\/2025\/10\/24\/obamacare-premiums-rise-30-percent\/\">Average Obamacare Premiums Are Set To Rise 30 Percent, Documents Show<\/a>,\u201d by Paige Winfield Cunningham<\/li>\n\n\n\n<li>KFF Health News\u2019 \u201c<a href=\"https:\/\/kffhealthnews.org\/news\/article\/florida-vaccine-mandates-ladapo-pediatricians-flu-measles-disease\/\">Doctors Muffled as Florida Moves To End Decades of Childhood Vaccination Mandates<\/a>,\u201d by Arthur Allen.<\/li>\n\n\n\n<li>CBS News\u2019 \u201c<a href=\"https:\/\/www.cbsnews.com\/news\/reproductive-health-trump-administration-hhs-cuts\/\">The Quiet Collapse of America\u2019s Reproductive Health Safety Net<\/a>,\u201d by C\u00e9line Gounder.<\/li>\n<\/ul>\n\n\n\n<section class=\"block--expandable has-label\"\n\t\t\tid=\"podcast-expandable\"\n\t>\n\t\t\t<input type=\"checkbox\" name=\"expandable-radio\" id=\"strong-transcript-happy-open-enrollment-eve-strong\">\n\t\t<label class=\"expandable__title-label\" for=\"strong-transcript-happy-open-enrollment-eve-strong\">\n\t\t\t\t\t\t\t<span\n\t\t\t\t\tclass=\"expandable__label  \"\n\t\t\t\t\tstyle=\"background-color: #cb1919;\"\n\t\t\t\t>\n\t\t\t\t\tClick to open the transcript\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span\n\t\t\t\t\tclass=\"expandable__title\"\n\t\t\t\t\tstyle=\"font-size: 36px;\"\n\t\t\t\t>\n\t\t\t\t\t\t<strong>Transcript: Happy Open Enrollment Eve!<\/strong>\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\t\t<div class=\"expandable__content--container\">\n\t\t<div class=\"expandable__content\">\n\t\t\t\n\n<p><em>[<\/em><strong><em>Editor\u2019s note:<\/em><\/strong><em> This transcript was generated using both transcription software and a human\u2019s light touch. It has been edited for style and clarity.]<\/em>&nbsp;<\/p>\n\n\n\n<p><strong>Julie Rovner:<\/strong> Hello, from KFF Health News and, starting this week, from WAMU public radio in Washington, D.C., and welcome to \u201cWhat the Health?\u201d I\u2019m Julie Rovner, chief Washington correspondent for KFF Health News, and I\u2019m joined by some of the best and smartest health reporters in Washington. We\u2019re taping this week on Thursday, Oct. 30, at 10 a.m. As always, news happens fast, and things might\u2019ve changed by the time you hear this. So here we go. Today, we are joined via video conference by Alice Miranda Ollstein of Politico.&nbsp;<\/p>\n\n\n\n<p><strong>Alice Miranda Ollstein:<\/strong> Hello.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Maya Goldman of Axios News.&nbsp;<\/p>\n\n\n\n<p><strong>Maya Goldman:<\/strong> Good to be here.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> And we welcome back to the podcast one of our original panelists, Paige Winfield Cunningham of The Washington Post. So great to see you again.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> Hi, Julie. It\u2019s great to be back.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Before we dive in, we have a little of our own news to announce. Starting this week, we\u2019re partnering with WAMU, Washington D.C.\u2019s public radio station, to distribute the podcast. That means you can also now find us on the NPR app. And welcome to all you new listeners. OK, onto the news. We are now 30 days into the federal government shutdown, and there is still no discernible end in sight. And this Saturday is not only the start of open enrollment in most states for the Affordable Care Act health plans, which we\u2019ll talk more about in a minute. It\u2019s also the day an estimated 42 million Americans will lose access to food stamps after the Trump administration decided to stop funding the SNAP [Supplemental Nutrition Assistance] program. That\u2019s something the administration did keep funding during the last Trump shutdown in 2019, and, according to budget experts, could continue to do now. So what\u2019s behind this? As I think I pointed out last week, not such a great look to deprive people of food aid right before Thanksgiving.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> So I think this follows the pattern we\u2019ve seen throughout the shutdown, which is just a lot of picking and choosing of what gets funded and what doesn\u2019t. The angle of this I\u2019ve covered is that out of all of the uniformed forces of the government, the Trump administration dug around and found money to keep paying the armed members, but not the public health officers, who are also part of the uniformed branches of the country. And yeah, you\u2019re seeing this in the SNAP space as well. President Trump and his officials have openly threatened to go after what they see as Democrat programs. So it\u2019s just interesting what they consider in that category. But you\u2019re seeing a lot of choices being made to exert maximum political pressure and force various sides of this fight to cave, but we\u2019re not seeing that yet either.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yeah, they are. I mean, it seems this is also backwards because it\u2019s usually the Republicans who are shutting down the government, the Democrats who are trying to pressure them to reopen it. And now, of course, we\u2019re seeing the opposite because the Democrats want the Republicans to do something about the Affordable Care Act subsidies, and the Republicans are going after previously what had been kind of sacrosanct bipartisan programs like food stamps and the WIC [the Special Supplemental Nutrition Program for Women, Infants, and Children] program, for pregnant and breastfeeding moms and babies. And now, apparently, they\u2019re going to stop funding for Head Start, the preschool program for low-income families with kids. On the one hand, you\u2019re right, they are programs that are very cherished by Democrats, but I feel like this whole shutdown is now sort of going after the most vulnerable people in America.&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> It\u2019s also been interesting because [Health and Human Services] Secretary [Robert F.] Kennedy [Jr.] has tried to use SNAP as a vehicle for his Make America Healthy Again agenda, right? Trying to get states to limit the sugary drinks that their SNAP programs offer. And he\u2019s, like, really touted that as part of the agenda. And now there does not seem to be any interest from HHS in speaking out about that.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Well, of course, and SNAP isn\u2019t an HHS program.&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> Exactly. Exactly.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> It\u2019s a program in the Department of Agriculture, which is even more confusing, but you\u2019re absolutely right. I mean, it\u2019s odd that some of the things that he\u2019s been pointing to are things that this administration is kind of trying to lay at the Democrats\u2019 feet, as in, <em>You want this program, reopen the government<\/em>. So as I mentioned, Saturday is the start of Obamacare open enrollment in most of the states. And, Paige, you got a <a href=\"https:\/\/www.washingtonpost.com\/health\/2025\/10\/24\/obamacare-premiums-rise-30-percent\/\" target=\"_blank\" rel=\"noreferrer noopener\">sneak peek at the premiums<\/a> for plans in the 30 states that use the federal marketplace, which is now open for what we call window-shopping before open enrollment officially begins. What did you find?&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> Yeah. So I got some documents at the end of last week showing that the average premium for the second-lowest-cost silver plan \u2014 which, of course, is what, we know \u2026 that\u2019s what the subsidies are pegged to \u2014 is going up 30%, which is the second-highest premium increase. The highest we saw was 2017 to 2018. But this is a really, really significant increase. And of course, CMS [the Centers for Medicare &amp; Medicaid Services] didn\u2019t include that number in the document that it finally released this week. So the documents I saw had some sort of numbers like that, which were all stripped out of the official documents. But all of this is just so interesting because I was thinking about, back to 2017-2018, and the politics of this are so flipped right now because basically it was the Democrats then who didn\u2019t want to talk about premium increases and the Republicans who were yelling about it.&nbsp;<\/p>\n\n\n\n<p>So it\u2019s funny how that has changed. But I guess on the politics of this, it seemed for a while like Democrats were thinking maybe the Nov. 1 start of open enrollment would provide this out for them to pass the spending bill because they could say, like, <em>OK, we tried<\/em>. <em>Now open enrollment has started, or the premiums are kind of baked, so we can\u2019t really do anything to change it now<\/em>. But I don\u2019t think we\u2019re going to have anything this week. It seems like both sides are pretty dug in still. I mean, I guess the other thing I would say on these costs, it\u2019s really highlighting a weakness that we\u2019ve known for a long time in the Affordable Care Act, which is that, like, yes, it made health insurance affordable for a lot of people, but there\u2019s always been this smaller number of people that are above 400% federal poverty that have had no shield from insurance costs. They have the last four years, and now they\u2019re not going to have one anymore. And it\u2019s funny because Democrats are talking about this, but that\u2019s sort of a problem they hadn\u2019t wanted to acknowledge for a long time in the early years of the Affordable Care Act. And as you guys all know, there\u2019s not going to be any political will for bipartisan work to create affordable options for these folks unless the subsidies get extended, which, of course, that doesn\u2019t seem very likely at the moment from how things stand.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yeah. Going back to what the Republicans sort of announced, their talking points, is that, well, first the premium increases aren\u2019t that big and that the expiring extra subsidies aren\u2019t that big a piece of it, both of which are actually kind of true. But, of course, that\u2019s not where the sticker shock is coming from. The sticker shock is coming from the expiration of those tax credits that\u2019s going to &#8230;&nbsp;&nbsp;<\/p>\n\n\n\n<p>So people who had been shielded from these very high premiums are no longer going to be shielded from them. And that\u2019s why, if you look at social media, you see all these screenshots now of insurance that costs $3,000 a month for people who were paying $150 a month, which is obviously not affordable. Why is it so difficult to explain the difference? I\u2019ve been working on different ways to explain it for the last three weeks.&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> I was trying to figure this out last night, when I was writing something for my newsletter today. And I think one of the really confusing parts about this is that, like Paige said, like Paige <em>scooped<\/em>, premiums are going up a certain amount, and that\u2019s not actually what people are seeing. That\u2019s not what almost anyone is going to actually face. Either you\u2019re getting that huge sticker shock because you\u2019re losing your subsidies that you had this year or you\u2019re continuing to have subsidies, they\u2019re not quite the same, but you\u2019re still not going to pay a 30% increase. And so I think that that\u2019s really confusing for me even, and hard to explain.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> I think one way to think about this is like the party that is going to bear the brunt of the premium costs to a large degree is the government because for people that are before 400% federal poverty, they are basically guaranteed under the Affordable Care Act that they\u2019re not going to have to pay more for premiums over a certain percentage of their income. And so this just means, like, the subsidies are getting really expensive for the federal government, which goes back to the issue of kind of like why Democrats didn\u2019t extend these enhanced premiums indefinitely \u2014 because it\u2019s just expensive to do it. This is the government subsidizing private health insurance. And then it\u2019s also significant again for those people over 400% poverty who had had a cap on what they would pay. I think it was 9.5% of their income under the enhanced \u2026 and now they have no cap.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> I think 8.5% of their income, actually, under the enhanced premiums.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> Under the enhanced. OK.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> It\u2019s going to go back to 10%.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> Yeah. Yeah. But there\u2019s no cap if you\u2019re like over, over 400%.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> 400%.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> Right. Yeah. Yeah.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> That\u2019s right.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> Yeah. But that\u2019s why people are confused. And the other thing is, like, the administration is correct, that the vast majority of people in the marketplaces will continue to get subsidies. And we are basically going back to what the situation was before covid, but it\u2019s that smaller number of people that are at the higher income levels. But the other thought I had was, of course, the health care industry and Democrats are talking a lot about this and spreading these huge premium increases far and wide and making sure everybody hears about them, but it\u2019s like a relatively small number of people, if you think about it.&nbsp;<\/p>\n\n\n\n<p>And I think it\u2019s only like a couple million people in the marketplaces who are at that higher income levels. And I wonder if that factors into Republicans\u2019 calculations here, where they\u2019re looking at how many voters are actually seeing these massive premium increases, having to pay for all of them. And in the whole scheme of the U.S. population, it\u2019s not like a ton of people. So I just wonder if that\u2019s one reason they\u2019re sort of, like, seem to be increasingly dug in on this and very reticent to extend these subsidies.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Although I would point out that when the Affordable Care Act started, it was only a small number of people who lost their insurance, and that became a gigantic political issue.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> This is very true.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> So it\u2019s the people who get hurt who sometimes yell the loudest, although you\u2019re right. I mean, at that point, the Democrats stayed the course and eventually, as Nancy Pelosi said, people came to like it. So it could work out the same way. It does help explain why everybody\u2019s still dug in. Maya, you wanted to say something.&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> I was just going to say, I think it\u2019ll be interesting to see, if subsidies aren\u2019t extended, how this affects premiums next year for people and for the federal government, because if a couple million people drop out of the ACA marketplace because it\u2019s too expensive, and those people tend to be healthier, then the remaining pool of people is sicker, and then that\u2019s the death spiral, right? So \u2026&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yeah. Although it is \u2026&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> Obviously, that\u2019s a lot of what ifs, but \u2026&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> \u2026 only the death spiral that goes back to prior to covid, which \u2014 it was kind of stable at 12 million. I\u2019m sort of amused by seeing Republicans complaining about subsidizing insurance companies. It\u2019s like, but this was the Republicans\u2019 idea in the first place, going back to the very origin of the ACA.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> And we should not forget that there is a group of people who are going to be losing all of their subsidies, not just the enhanced subsidies. And that\u2019s legal immigrants, and that\u2019s hundreds of thousands of people. So, like Maya said, that will probably mean a lot of younger, healthier people dropping coverage altogether, which will make the remaining pool of people more expensive to insure. So these things have ripple effects, things that impact one part of the population inevitably impact other parts of the population. And again, these are legal tax-paying immigrants with papers \u2014 will be subject to the full force of the premium increases because they won\u2019t have any subsidies.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yes, our health system at work. All right, we\u2019re going to take a quick break. We will be right back with more health news.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Moving on, the federal government is technically shut down, but the Trump administration is still making policy. You might remember last summer, a federal judge blocked a Biden administration rule that prevented medical debt from appearing on people\u2019s credit reports. The Trump administration chose not to appeal that ruling, thus killing the rule. Now the administration is going a step further \u2014 this week, <a href=\"https:\/\/kffhealthnews.org\/news\/article\/medical-debt-trump-consumer-financial-protection-bureau-reverses-credit-protections\/\" target=\"_blank\" rel=\"noreferrer noopener\">putting out guidance<\/a> that tries to stop states from passing their own laws to prevent medical debt from ruining people\u2019s credit, and often their ability to rent, or buy a house, or purchase a car, or even sometimes get a job. According to the acting head of the federal Consumer Financial Protection [Bureau], Russell Vought \u2014 yes, that same Russell Vought who\u2019s also cutting federal programs as head of the Office of Management and Budget \u2014 states don\u2019t have the authority to restrict medical debt from appearing on credit reports, only the federal government does, which of course he has already shown he doesn\u2019t want to do. Who does this help? I\u2019m not sure I see what the point is of saying <em>we\u2019re not going to do it and states, you can\u2019t do it either<\/em>. Part of this, I know, is Russell Vought has made no secret of the fact that he would like to undo as much of the federal government as he can. In this case, is he doing the bidding of, I guess it\u2019s the people who extend credit, who, I guess, want this information, want to know whether people have medical debt, think that that\u2019s going to impact whether or not they can pay back their loans, or is this just Russell Vought being Russell Vought?&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> I guess, in theory, maybe it goes back to the idea that if you have consequences for medical debt, then people will pay their bills, and maybe that would help the health systems in the long run. But I also think that \u2014 I don\u2019t know what health systems have said about this particular move, to be honest \u2014 but I think there\u2019s an interest in making medical debt less difficult for people to bear in the whole health system. So I\u2019m not sure how popular that is.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yeah. Yes. Another one of those things that\u2019s sort of like, <em>we\u2019re going to hurt the public to thwart the Democrats<\/em>, which kind of seems to be an ongoing theme here. Well, as we tape this morning, the Senate health committee was supposed to be holding a hearing on the nomination of RFK Jr. MAHA ally Casey Means to be U.S. surgeon general. Casey Means was going to testify via video conference because she is pregnant, but, apparently, she has gone into labor, so that hearing is not happening. We will pick up on it when that gets rescheduled. Perhaps she will appear with her infant.&nbsp;<\/p>\n\n\n\n<p>Back at HHS, a U.S. district judge this week indefinitely barred the Trump administration from laying off federal workers during the shutdown, but at the Centers for Disease Control and Prevention, it appears the damage is already done. The New York Times\u2019 global health reporter, Apoorva Mandavilli, reports that the agency appears to have had its workforce reduced by a third and that the entire leadership now consists of political appointees loyal to HHS secretary Kennedy, who has not hidden his disdain for the agency and the fact that he wants to see it dissolved and its activities assigned elsewhere around the department. What would that mean in practice if there, in effect, was no more CDC?&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> Hopefully we don\u2019t have another pandemic. There\u2019s just a lot of stuff the CDC does. And it\u2019s been really confusing to follow these layoffs because in this last round, I remember trying to figure out with my colleague Lena Sun how many people were sent notices and then hundreds were sort of, those were rescinded and they were brought back. But yeah, I mean, I think we\u2019re going to see the effects of this over the next couple of years. When I\u2019ve asked the administration broadly about the reductions to HHS, what they say is that the agency overall has grown quite a lot in its headcount through the pandemic, which is true. I think they got up to like 90,000 or so. And then, according to our best estimates, maybe they\u2019re back around 80,000, although I\u2019m not entirely sure if that\u2019s accurate. Again, it\u2019s really been hard to track this.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yeah. I\u2019ve seen numbers as low as 60,000.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> It may be lower. Yeah. Yeah. So I think actually the 80,000, that may have been the headcount before the pandemic. Anyway, all that to say, it did grow during the pandemic, and that\u2019s kind of the argument that they\u2019re making, is that they\u2019re just bringing it back to pre-pandemic levels.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> But CDC, I mean, it really does look like they want to just sort of devolve everything that CDC does to the states, right? I mean, that we\u2019re just not going to have as much of a federal public health presence as we\u2019ve had over these past 50, 60 years.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> For sure. They\u2019ve definitely targeted CDC. I mean, they mostly left CMS alone and FDA because, statutorily, I think it\u2019s easier for them to shrink CDC, but it definitely is going to have massive effects over the next couple of years, especially as we see future pandemics.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> And the whole argument about returning to pre-covid, that doesn\u2019t fit with what they\u2019re actually cutting. I mean, they\u2019re gutting offices that have been around for decades \u2014 focused on smoking, focused on maternal health, all these different things. And so this is not just rolling back increases from the past few years. This is going deeper than that.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> Well, yeah, it\u2019s not like they\u2019re just cutting the roles that were added since the pandemic.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> Exactly.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> It\u2019s not a last-in, first-out kind of thing. Well, as I said, since it looks like public health is now mostly going to be devolved to the states, let\u2019s check in on some state doings. In Florida, where state Surgeon General Joseph Ladapo last month announced a plan to end school vaccination mandates. My KFF Health News colleague <a href=\"https:\/\/kffhealthnews.org\/news\/article\/florida-vaccine-mandates-ladapo-pediatricians-flu-measles-disease\/\" target=\"_blank\" rel=\"noreferrer noopener\">Arthur Allen has a story<\/a> about how health officials, including university professors and county health officials, who actually do believe in vaccinating children, are effectively being muzzled, told they cannot speak to reporters without the approval of their supervisors, who are likely to say no. Seeing the rising number of unvaccinated children in a state like Florida, where so many tourists come and go, raising the likelihood of spreading vaccine preventable diseases, this all seems kind of risky, yes?&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> Yes. That was a fantastic article from your colleague, and there was a really illuminating line, which I think had been reported before, but a reporter asked the surgeon general if he had done any disease modeling before making the decision. And he said, <em>Absolutely not<\/em>, because this to him was a personal choice issue and not a public health issue. And I think that just goes to show that we have no idea what is going to happen as a result of this public health decision and it could have massive ripple effects.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> But what we are already seeing are the rise of vaccine-preventable diseases around the country. I mean, measles, first in Texas, now in South Carolina; whooping cough in Louisiana; I\u2019m sure I am missing some, but we are already seeing the consequences of this dwindling herd immunity, if you will. Alice, you\u2019re nodding your head.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> Yeah. And I\u2019ve heard from experts that measles is really sort of the canary in the coal mine here because it\u2019s so infectious. It spreads so easily. You can have an infected person cough in a room and leave the room, and then a while later, someone else comes in the room and they can catch it. Not all of these vaccine-preventable illnesses are like that. So the fact that we\u2019re seeing these measles outbreaks is an indication that other things are probably spreading as well. We\u2019re just not seeing it yet, which is pretty scary.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> And of course, one of the things that the CDC does is collect all of that data, so we\u2019re probably not seeing it for that reason, too. Well, meanwhile, in Texas, Attorney General and Republican Senate candidate Ken Paxton is suing the makers of Tylenol. He\u2019s claiming that Johnson &amp; Johnson spun off its consumer products division \u2014 that includes not just Tylenol, but also things like Band-Aids and Baby Shampoo \u2014 to shield it from liability from Tylenol\u2019s causing of autism, something that has not been scientifically demonstrated by the way \u2014 even Secretary Kennedy admits that has not been scientifically demonstrated. My recollection, though, is that Johnson &amp; Johnson was trying to shield itself from liability when it spun off its consumer products division, but not because of Tylenol, rather from cancer claims related to talc in its eponymous Baby Powder. So what\u2019s Paxton trying to do here beyond demonstrate his fealty to President Trump and Robert F. Kennedy Jr.?&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> I was interested to see some GOP senators distancing themselves from the Texas lawsuit and saying like, <em>Look, there is no proof of this connection and this harm<\/em>. <em>Let\u2019s not go crazy<\/em>. But as I\u2019ve reported, it\u2019s just very hard to get good information out to people because there just isn\u2019t enough data on the safety of various drugs, because testing drugs on pregnant women was always hard and it\u2019s gotten even harder in recent years. And so, based on the data we have, this is a correlation, not causation. But it would be easier to allay people\u2019s fears if we had more robust and better data.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yeah. Does a lawsuit like this, though, sort of spread the \u2026 give credence to this idea that \u2014 I see you nodding, Maya \u2014 that there is something to be worried about using Tylenol when pregnant? Which is freaking out the medical community because Tylenol is pretty much the only drug that currently is recommended for pregnant women to deal with fever and pain.&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> Yeah. I think some of my colleagues have reported on the concern of another death spiral here, right? Where people get concerned, perhaps without basis, of taking Tylenol or any other drugs, vaccines even, because there are lawsuits and then the makers of these drugs say it\u2019s not worth it for us to make these anymore. And then they don\u2019t make them. And then it\u2019s like a bad cascade of events. And so it\u2019s obviously too soon to see if that\u2019s what\u2019s happening here, but it\u2019s certainly something to watch.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> But as we\u2019ve pointed out earlier, not treating, particularly, fever can also cause problems. So \u2026&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> Right. Basically all of the alternatives are more dangerous. Not taking anything to treat pain and fever in pregnancy can be dangerous and can lead to birth effects. And taking other painkillers and fever reducers are known to have dangerous side effects. Tylenol was the safest option known to science. And now that that\u2019s being questioned in the court of public opinion, people are worried about these ramifications.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> I think about the effect on moms who have kids with autism who are now thinking back to their pregnancies and thinking, <em>Oh my gosh, how much Tylenol did I take?<\/em> I know I took, I had pregnancies that I took plenty of Tylenol during. My nephew has autism, and I was talking to my sister about this, and she was like, &#8220;I took Tylenol.&#8221; And what they\u2019re doing is, I guess, other reflection I have on it is, in general, there\u2019s just less research on most things than we need. And there are some studies showing a correlation, which as we all know is not causation. And what it looks like the administration did was they took those tiny little nuggets of suggestions and have blown them up into this overly confident declaration of Tylenol and pregnancy and probably unnecessarily causing many women to blame themselves or think, <em>Should I have done something differently during my pregnancy? <\/em>when they were really just doing what their doctor recommended they do.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> I\u2019m surprised that we haven\u2019t seen legal action from Tylenol yet. I imagine we might at some point, especially if there is some kind of government action around this, like a label change. I think we will see some sort of legal action from the company because this is absolutely going to impact their bottom line.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yeah. All right. Well, finally this week, more news on the reproductive health front. California announced it would help fund Planned Parenthood clinics so they can continue providing basic health services, as well as reproductive health services, after Congress made the organization ineligible for Medicaid funds for a year and the big budget bill passed last summer. California\u2019s the fourth state to pitch in joining fellow blue states Washington, Colorado, and New Mexico. Meanwhile, family planning clinics in Maine are closing today due to that loss of Medicaid funding. And at the same time, the Health and Human Services Office of Population Affairs, which oversees the federal family planning program, Title X, is down apparently from a staff of 40 to 50 to a single employee, <a href=\"https:\/\/www.cbsnews.com\/news\/reproductive-health-trump-administration-hhs-cuts\/\" target=\"_blank\" rel=\"noreferrer noopener\">according to my colleague C\u00e9line Gounder<\/a>. Is contraception going to become the next health care service that\u2019s only available in blue states, Alice?&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> So Title X has been in conservatives\u2019 crosshairs for a long time. There have been attempts on Capitol Hill to defund it. There have been various policies of various administrations to make lots of changes to it. Some of those changes have really limited who gets care. And so it\u2019s been a political football for a while. Of course, Title X doesn\u2019t just do contraception. It\u2019s one of the major things they do, providing subsidized and sometimes even free contraception to millions of low-income people around the country. But they also provide STI testing, even some infertility counseling and other things, cancer screenings. And so this is really hitting people at the same time as the anticipated Medicaid cuts, and at the same time Planned Parenthood clinics are closing because they got defunded. And so it\u2019s just one on top of another in the reproductive health space. Each one alone would be really impactful, but taken all together, yeah, there\u2019s a lot of concern about people losing access to these services.&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> I think the politics of this are more interesting to me than the practical effect. I mean, under the ACA, birth control has to be covered, right? by marketplace plans. Generally speaking, if people have insurance, they do have coverage for a range of birth control. But the Title X program is interesting because it seems to like overlap between the MAHA priorities and the social conservatives. Of course, as Alice said, this has long been a target of social conservatives. I think in Project 2025 called for any Title X, I believe. And then there\u2019s this current in the MAHA movement that\u2019s kind of like anti-hormonal birth control and there\u2019s also these kinds of streams of pronatalist people, of <em>have more babies, don\u2019t take birth control<\/em>. So that\u2019s kind of interesting to me because there\u2019s this larger narrative I think in HHS right now of the RFK MAHA people versus the traditional conservative, anti-abortion people. So that\u2019s just like one program where I see overlap between the two.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> One of my favorite pieces of congressional trivia is that Title X has not been reauthorized since 1984, which, by the way, is before I started covering this. But I\u2019ve been doing this 39 years and I have never covered a successful reauthorization of the Title X program. So it\u2019s obviously been in crosshairs for a very, very long time. Maya, did you want to add something?&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> I was just going to say to Paige\u2019s point, telling women that they can\u2019t take any painkillers during pregnancy is not a good way to raise the birth rate.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yes. That\u2019s also a fair point. Well, meanwhile, red states are trying to expand the role of crisis pregnancy centers, which provide mostly nonmedical services and try to convince those with unplanned pregnancies not to have abortions. In Wyoming, state lawmakers are pushing a bill that would prohibit the state or any of the localities from regulating those centers &#8220;based on the center\u2019s stance against abortion.\u201d This comes after a similar proposal became law in Montana, the efforts being pushed by the anti-abortion group Alliance Defending Freedom. Is the idea here to have crisis pregnancy centers replace these Title X clinics and Planned Parenthoods?&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> I think there are a lot of people that would like to see that, but, as you said, they do not provide the same services, so it would not be a one-to-one replacement. Already, there are way more crisis pregnancy centers around the country than there are Planned Parenthood clinics, for example, but that doesn\u2019t mean that everyone has access to all the services they want.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> And many of these crisis pregnancy centers don\u2019t have any medical personnel, right? I mean, some of them do, but \u2026&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> It\u2019s really a range. I mean, some have a medical director on staff, or maybe there\u2019s one medical person who oversees several clinics, some do not. Some offer ultrasounds, some don\u2019t, some just give pamphlets and diapers and donated items. It\u2019s just really a range around the country. And states have also been grappling with how much to, on the conservative side, support and fund such centers. And on the other side, states like California have really gone to battle over regulating what they tell patients, what they\u2019re required to tell patients, what they can\u2019t tell patients. And that\u2019s gotten into the courts and they\u2019ve fought over whether that violates their speech rights. And so it\u2019s a real ongoing fight.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yes, I\u2019m sure this will continue. All right, that is the news for this week. Now it\u2019s time for our extra-credit segment. That\u2019s where we each recognize a story we read this week we think you should read too. Don\u2019t worry if you miss it; we\u2019ll put the links in our show notes on your phone or other mobile device. Maya, why don\u2019t you go first this week?&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> Sure. So this story is from KFF Health News and New England Public Media. It\u2019s called \u201c<a href=\"https:\/\/kffhealthnews.org\/news\/article\/sports-betting-state-regulation-gambling-addiciton-massachusetts\/\" target=\"_blank\" rel=\"noreferrer noopener\">As Sports Betting Explodes, States Try To Set Limits To Stop Gambling Addiction<\/a>,\u201d by Karen Brown. And I think this stood out to me because I was just in Vegas last week for health, but this, I think, is a really interesting issue to explore through a public health lens, the issue of sports betting and betting addiction. And there are states that are trying to do a lot of work around this and just organizations. And then of course the gaming companies themselves have their own pushback on that, and I think this story just lays it out really well and it\u2019s an important issue that gets very overlooked.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yeah, it is a public health issue, an interesting one. Alice?&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> I chose a story from ProPublica by reporter, Eric Umansky, and it\u2019s called \u201c<a href=\"https:\/\/www.propublica.org\/article\/veterans-affairs-male-breast-cancer-coverage-trump-executive-order\" target=\"_blank\" rel=\"noreferrer noopener\">Citing Trump Order on \u2018Biological Truth,\u2019 VA Makes It Harder for Male Veterans With Breast Cancer To Get Coverage<\/a>.\u201d So this is one of many examples that you could give of policies intended to target transgender folks having spillover effects and impacting cisgender folks, too. In this instance, it\u2019s now harder for male veterans to qualify to get treatment for breast cancer. Men can get breast cancer. Let\u2019s just say that. Men can and do get breast cancer, and it can be harder to detect and very lethal, and obviously very expensive to treat if you don\u2019t have coverage. And so this story has a lot of sad quotes from folks who are losing their coverage, especially because they likely acquired cancer by being exposed during their service to various toxic substances. And so I think, yeah.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yeah. A combination of a lot of different factors in that story.&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> Definitely.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Paige?&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> Yeah. So my story is by, actually, my colleague Mark Johnson. I sit next to him at The [Washington] Post, and the headline is \u201c<a href=\"https:\/\/www.washingtonpost.com\/science\/2025\/10\/23\/vaccine-cancer-covid-19-mrna\/?utm_campaign=wp_main&amp;utm_source=twitter&amp;utm_medium=social\" target=\"_blank\" rel=\"noreferrer noopener\">Study Finds mRNA Coronavirus Vaccines Prolonged Life of Cancer Patients<\/a>.\u201d I was really struck by this story because it talks about how patients with advanced lung cancer, they were given the covid vaccines and it somehow had the effect of supercharging their immune systems. And, actually, their median survival rates went up by 17 months compared with those that weren\u2019t given the vaccines. And, of course, this administration has really gone after the covid vaccines and the mRNA research, in particular, and canceled $500 million in funding for mRNA research. And all of the ACIP\u2019s [Advisory Committee on Immunization Practices\u2019] moves on vaccines have gotten so much attention. But I think the thing that also is going to be perhaps even more impactful is pulling back on this really promising research, because it has sort of become politicized because the covid vaccines have become politicized. And it seems a shame that we\u2019re pulling back on this really promising research. So I thought that was a really interesting story by my colleague.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Yes. Yet another theme from 2025. My extra credit this week is from my KFF Health News colleague Bernard J. Wolfson, and it\u2019s called \u201c<a href=\"https:\/\/kffhealthnews.org\/news\/article\/medical-school-federal-loan-caps-doctor-shortage-trump-law\/\" target=\"_blank\" rel=\"noreferrer noopener\">Many Fear Federal Loan Caps Will Deter Aspiring Doctors and Worsen MD Shortage<\/a>.\u201d And it\u2019s a good reminder about something we did talk about earlier this year when the Republican budget bill passed. It limits federal grad school loans to $50,000 per year at a time when the median tuition for a year in medical school is more than $80,000. The idea here is to push medical schools to lower their tuition, but in the short run, it\u2019s more likely to push lower-income students either out of medicine altogether or to require them to take out private loans with more stringent repayment terms, which could in turn push them into pursuing more lucrative medical specialties rather than the primary care slots that are already so difficult to fill. It\u2019s yet another example of how everybody agrees on a problem: Medical education is way too expensive in this country. But nobody knows quite how to fix it.&nbsp;&nbsp;<\/p>\n\n\n\n<p>OK. That is this week\u2019s show. Thanks this week to our editor, Emmarie Huetteman, and our producer-engineer, Francis Ying. A reminder, \u201cWhat the Health?\u201d is now available on WAMU platforms, the NPR app, and wherever else you get your podcasts, as well as, of course, kffhealthnews.org. If you already follow the show, nothing will change. The podcast will show up in your feed as usual. Also, as always, you can email us your comments or questions. We\u2019re at whatthehealth@kff.org, or you can find me at X, <a href=\"https:\/\/twitter.com\/jrovner\" target=\"_blank\" rel=\"noreferrer noopener\">@jrovner<\/a>, or on Bluesky, <a href=\"https:\/\/bsky.app\/profile\/julierovner.bsky.social\" target=\"_blank\" rel=\"noreferrer noopener\">@julierovner<\/a>. Where are you folks hanging these days? Maya?&nbsp;<\/p>\n\n\n\n<p><strong>Goldman:<\/strong> I am on X as <a href=\"https:\/\/x.com\/mayagoldman_?lang=en\" target=\"_blank\" rel=\"noreferrer noopener\">@mayagoldman_<\/a> and I\u2019m also on <a href=\"https:\/\/www.linkedin.com\/in\/maya-goldman-680018154\/\" target=\"_blank\" rel=\"noreferrer noopener\">LinkedIn, just under my name<\/a>.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Alice?&nbsp;<\/p>\n\n\n\n<p><strong>Ollstein:<\/strong> <a href=\"https:\/\/bsky.app\/profile\/alicemiranda.bsky.social\" target=\"_blank\" rel=\"noreferrer noopener\">@alicemiranda<\/a> on Bluesky and <a href=\"https:\/\/x.com\/aliceollstein?lang=en\" target=\"_blank\" rel=\"noreferrer noopener\">@AliceOllstein<\/a> on X.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Paige?&nbsp;<\/p>\n\n\n\n<p><strong>Winfield Cunningham:<\/strong> I am still <a href=\"https:\/\/x.com\/pw_cunningham\" target=\"_blank\" rel=\"noreferrer noopener\">@pw_cunningham<\/a> on X.&nbsp;<\/p>\n\n\n\n<p><strong>Rovner:<\/strong> Great. We will be back in your feed next week. Until then, be healthy.&nbsp;<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/section>\n\n\n\n<div class=\"wp-block-credits block--credits\">\n\t\t<h3 class=\"credits-title\">\n\t\tCredits\t<\/h3>\n\t\t<div class=\"credits-card-container twowide\">\n\t\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Francis Ying<\/div>\n\t<div class=\"author-affiliation\">Audio producer<\/div>\n\t\t\t\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-people-card block--people-card\">\n\t\t\t<div class=\"author-meta-container\">\n\t<div class=\"author-name\">Emmarie Huetteman <\/div>\n\t<div class=\"author-affiliation\">Editor <\/div>\n\t\t\t\t\t\t<div class=\"author-bio\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><em><a href=\"https:\/\/kffhealthnews.org\/our-podcasts\/\"><u>Click here to find all our podcasts.<\/u><\/a><\/em><\/p>\n\n\n\n<p><em>And subscribe to &#8220;What the Health? From KFF Health News&#8221; on <a href=\"https:\/\/podcasts.apple.com\/us\/podcast\/what-the-health\/id1253607372?mt=2\"><u>Apple Podcasts<\/u><\/a>, <a href=\"https:\/\/open.spotify.com\/show\/32EdsB662C3oyIrqLMmBXI?si=TQhRjzzLTgWtK3crfbOFtA\"><u>Spotify<\/u><\/a>, <em><a href=\"https:\/\/app.npr.org\/aggregation\/fis-1269164038\"><u>the NPR app<\/u><\/a>,<\/em> <a href=\"https:\/\/www.youtube.com\/playlist?list=PL5Qew-7pSXbAucCUQnyRx6qpLglzrxzFb\" target=\"_blank\" rel=\"noopener\">YouTube<\/a>, <a href=\"https:\/\/play.pocketcasts.com\/web\/podcasts\/a379e280-3f57-0135-9028-63f4b61a9224\"><u>Pocket Casts<\/u><\/a>, or wherever you listen to podcasts.<\/em><\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A standoff in Congress is keeping much of the government shut down as open enrollment begins in most states for Affordable Care Act plans. Democrats are demanding Republicans agree to extend ACA tax credits, but there has been little negotiating \u2014 even as customers are learning what they\u2019ll pay for coverage next year. Meanwhile, the Trump administration is telling states they can\u2019t pass their own laws to keep medical debt off consumers\u2019 credit reports. Paige Winfield Cunningham of The Washington Post, Maya Goldman of Axios, and Alice Miranda Ollstein of Politico join KFF Health News\u2019 Julie Rovner to discuss those stories and more.<\/p>\n","protected":false},"featured_media":2103181,"template":"","meta":{"_cr_original_post":"2103176","_cr_replace_post_id":"","_cr_replacing_post_id":"","jetpack_post_was_ever_published":false,"kaiser_health_news_featured_image_caption":"","kaiser_health_news_header_theme_slug":"","kaiser_health_news_hero_image":0,"kaiser_health_news_backdrop_padding":115,"kaiser_health_news_kicker":"What the Health? 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Democrats are demanding Republicans agree to extend ACA tax credits, but there has been little negotiating \u2014 even as customers are learning what they\u2019ll pay for coverage next year. Meanwhile, the Trump administration is telling states they can\u2019t pass their own laws to keep medical debt off consumers\u2019 credit reports. Paige Winfield Cunningham of The Washington Post, Maya Goldman of Axios, and Alice Miranda Ollstein of Politico join KFF Health News\u2019 Julie Rovner to discuss those stories and more.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/kffhealthnews.org\/news\/podcast\/what-the-health-420-open-enrollment-obamacare-aca-shutdown-october-30-2025\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Happy Open Enrollment Eve! - KFF Health News\" \/>\n<meta property=\"og:description\" content=\"A standoff in Congress is keeping much of the government shut down as open enrollment begins in most states for Affordable Care Act plans. 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