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 skilled 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 Revenue Safety Act, higher often known as ERISA. Whereas the legislation was primarily supposed to manage and defend employee pensions, it additionally basically modified how medical health insurance is supplied and controlled in the USA. Fifty years on, ERISA performs a task in practically each element of medical health insurance and has had a profound impression 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 specialists 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: Blissful fiftieth, ERISA
KFF Well being Information’ ‘What the Well being?’ Episode Title: ‘Blissful fiftieth, ERISA’ Episode Quantity: 360Printed: 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 a few of the greatest and smartest well being reporters in Washington, however right now, we now have a particular episode for you. We’re taping this week on Monday, Aug. twelfth, at 2 p.m. As all the time, 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 in the event you comply with well being coverage, you’re probably acquainted with 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 a couple of.
One chances are you’ll not have heard as a lot about is ERISA, the Worker Retirement Revenue Safety Act, which was signed in 1974 by then-President Gerald Ford. This fall marks 50 years since ERISA turned legislation. ERISA, as its title suggests, is usually about defending pension advantages for staff. It was impressed, at the least partially, by the collapse of a pension fund when a plant that constructed Studebaker vehicles in Ohio shut down in 1963. However, at the least 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 lot of how well being advantages are regulated within the U.S.
I’m happy to have an all-star panel right here to hitch us to speak about what ERISA has meant to well being coverage and what it’s prone to imply going ahead because it begins its second half-century. Larry Levitt is government vice chairman for coverage right here at KFF and certainly one of only some folks 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 training. Paul has additionally taught me extra about ERISA over time than most likely another single individual.
Lastly, Ilyse Schuman is senior vice chairman of the American Advantages Council, which represents massive employers and different suppliers of well being and retirement advantages by means 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 whole lot 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 originally. How did well being advantages wind up being coated in a legislation that was aimed toward retiree pensions?
Paul Fronstin: None of us had 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 mentioned, the supply was inserted on the final minute, however I feel there have been a whole lot of conversations about it main as much as it being inserted on the final minute. I feel a whole lot 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 usually in existence earlier than ERISA handed.
And clearly these plans needed some federal safety concerning what they had been doing, and the states needed extra regulation. And I’ve learn a little bit bit about this over time, and there was definitely some lobbying for and in opposition to having a provision in there to guard self-insured plans from state regulation. So the conversations had been occurring. It simply … the language most likely simply didn’t make it into the laws until the final minute.
Schuman: And I feel definitely the panorama again in 1974, as Paul talked about, was that increasingly states had been creating, with respect to well being care, their very own variations of varied legal guidelines. And so self-funded plans, massive employers like our members — quite a lot of them had been again in existence 50 years in the past, some weren’t — had been discovering it more and more troublesome to have the ability to administer their self-funded plans on a uniform foundation nationwide.
So it wasn’t within the backrooms after they had been really drafting the laws, however definitely notice that the nationwide panorama on this rising patchwork of state well being legal guidelines was turning 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, they usually paid 80% of it. This was a time when PPOs [preferred provider organizations] had been beginning, managed care, HMOs had been actually simply getting their begin. So there was a necessity for far 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 12 months earlier than. So HMOs had been simply approaching the scene, and that will have performed into this as properly.
Rovner: So again in 1945, when actually none of us had been within the room, Congress handed one thing referred to as the McCarran-Ferguson Act, which was supposed to make sure that states quite than the federal authorities retained the authority to manage insurance coverage. What occurred in ERISA to alter that? Ilyse, I feel you had been already form of referring to this. And what will we imply once we discuss ERISA preemption? That’s a phrase that folks hear quite a bit and their eyes glaze over.
Schuman: Positive. Nicely, their eyes could glaze over but it surely actually is foundational to hundreds of thousands of Individuals and their households which might be 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 chance as providing these advantages as a substitute of the provider.”
Rovner: So that they’re not really 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 might be 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 people who don’t. Admittedly, a lot of people who self-fund are bigger employers, however once more, they are saying that “We are going to take the chance of paying for the claims of our medical health insurance protection as a substitute of the provider. However together with that, we get the pliability 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 modern 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 discuss by means of the form 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: “In case 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 in the event you’re in legislation faculty, 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; which means that they don’t must adjust to these state insurance coverage legal guidelines.
Levitt: And right here’s the place this will get actually tangible for folks, proper? So 150 million folks have insurance coverage protection by means 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 putting in don’t apply to most individuals with employer-sponsored insurance coverage as a result of they’re in these self-funded plans.
Rovner: And, in fact, the persevering with issues that lots of people who’re in these self-funded plans don’t comprehend 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 is just not 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’d flip to with an issue along with your insurance coverage?” And actually zero folks mentioned 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 may be that UnitedHealthcare is administering this self-funded plan, however you, as an worker on this plan, haven’t any method 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 simply’ve by no means even heard of which might be 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 totally insured plans.
Schuman: Proper.
Fronstin: So totally insured plans are regulated each by ERISA and on the state stage. And then you definitely’ve acquired 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 once we discuss ERISA, preemption, and self-insurance. That’s only one facet of ERISA.
Schuman: And I feel to the purpose about workers unsure what covers them, what doesn’t cowl them. Once more, for self-funded massive employers, I imply, I feel a lot of the workers 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 advanced than, OK, in the event you’re an worker working in Kentucky, you have got one plan. In case you’re an worker working in New York, you have got one other plan. And workers speaking to one another and saying, “Hey, how come you have got 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 likewise, two issues about form of the advantages and what’s coated. There’s a distinction between a state saying, “OK, you need to cowl this profit and must 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 method nationwide.”
And keep in mind, ERISA, if the federal authorities, because it has completed over the previous, desires to make modifications to … which might be relevant to group well being plans, it will probably amend and has amended ERISA to try this. So the market reforms, for instance, within the Reasonably priced Care Act, had been relevant, and the Public Well being Service Act, had been form of included into ERISA. The Genetic Info Nondiscrimination Act, for instance, amended ERISA. So it’s like that’s the lever to make modifications to ERISA that will likely be relevant to self-funded plans as properly is on the federal stage.
Rovner: Once I was first masking Congress within the 19… late-Eighties and early-Nineties, you didn’t go there. In case you needed to do one thing about well being coverage, you didn’t contact ERISA. I feel lawmakers had been afraid of reopening it and moving into every kind 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 official protection. So in the event you have a look at what the ACA did, and as Ilyse mentioned, these utilized to all employers, all group well being plans by means of the amendments to ERISA.
And these had been issues like no preexisting situation exclusions, protection of preventive companies with no affected person price sharing, no annual on lifetime limits, a cap on out-of-pocket prices. And possibly the preferred provision of the ACA, protection of dependents as much as age 26. There was no method to attain everybody with insurance coverage with out amending ERISA beneath 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. Nicely, there’s been a few situations of that. And positively the Clinton well being plan tried this and didn’t succeed within the early 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 had 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 actually have a good deal with on how many individuals are coated by church plans as a result of a whole lot of them are usually small companies, they usually could not even provide 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 just like ERISA, but it surely’s not ERISA.
Schuman: And I feel once we discuss coated by ERISA, definitely it’s, What does ERISA afford? It’s not nearly self-funded employers having the ability to provide uniform advantages nationwide. There are essential protections. There are essential disclosure necessities for workers, for contributors which might be included in there which might be 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 thought 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 might be embedded within the legislation for the good thing about contributors.
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 simply be informed every little thing that your plan covers.
Schuman: Proper. Appropriate.
Rovner: So, Larry, you form 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, in the event you had been injured or somebody died on account of being denied care, the one factor that they might get well 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 in the event you’re injured — you possibly can’t go to your state regulatory company?
Levitt: No, there have been some modifications 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 folks in comparison with a state insurance coverage division.
I feel it’s actually this construction of ERISA that, Julie, you mentioned folks had been all the time proof against amending in Congress, that has been proof against modification, proper? I imply, this concept that states regulate insurance coverage instantly however that states can not regulate group well being plans beneath ERISA. And that’s had far-reaching well being coverage implications. So states seeking to do employer mandates or something that instantly 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 may be some methods round ERISA by means 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 are able to 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 mentioned 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 basic for the power of multistate employers to sponsor profit plans to staff nationwide. So I feel simply form of getting again into the minds of the drafters of ERISA, that cut price, if you’ll, that turned ERISA preemption was actually foundational to the legislation passing.
Rovner: And you would see why it might make sense. In case 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 acquired, definitely, post-pandemic or after the pandemic, an more and more cell and distant workforce. And we now have heard repeatedly about how ERISA preemption actually promotes that employee mobility and the power to work out of your own home in one other state or to have the ability to switch from one location to a different.
So suppose a little bit bit if we simply see how the workforce itself has advanced, I feel that ERISA preemption provision could develop into much more essential. And I feel more and more, it’s not simply massive employers that discover themselves — like nationwide or multistate employers — however as a result of the workforce is extra distant and cell, and needs to be, that increasingly employers of multistate employers, too.
Levitt: I’d say we now have more and more seen smaller employers self-funding, and there are some benefits to that, proper? They don’t essentially must 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 inventive methods of permitting smaller companies to self-fund and avoiding a few of the danger by layering numerous reinsurance on high 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 totally different well being plans in 50 totally different states. And to the diploma you’ve acquired the states doing one thing — whether or not it’s a single-payer or one thing wanting that — employers, they only need to provide everybody the identical profit and make it as straightforward as potential to take action.
And my concern is that if they needed to adjust to 50 totally different state legal guidelines to take action or create 50 totally different profit plans, particularly right now with the ACA assured concern and sponsored protection, you’ll get to the purpose the place if employers didn’t have the power to supply one profit plan throughout all 50 states, they’re not going to do it anymore, proper? They’ve acquired … pre-ACA would possibly’ve been totally different, however now they’ve acquired an alternate the place their workers may get protection in the event that they didn’t provide protection themselves.
Rovner: In order that was all predicted. This enormous motion away from employer-provided protection after the ACA handed was predicted, and it didn’t occur.
Fronstin: I used to be a kind of folks predicting it. Yeah. Earlier than the ACA handed, I used to be a kind of folks 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, they usually haven’t had an excellent 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 charge 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 workers for a similar factor they had 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 form 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 will 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 would like 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, definitely 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, in the event you Google ERISA, you get every kind of lawsuits and challenges. And I imply, it’s nonetheless a really energetic 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 concern 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 appearing as applicable fiduciaries in attempting to get the bottom prices, significantly for prescribed drugs. And these began out as form 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: Nicely, I feel that employers seeing the rising variety of states which might be attempting to chip away, if not erode in a basic method, ERISA preemption is de facto alarming. Lots of these efforts have come up round pharmacy profit managers and efforts to manage pharmacy profit managers on the state stage.
However the best way that they’ve completed it, the states have actually taken direct goal 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 trying on the rising variety of states which might be excited by passing legal guidelines that actually 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 impression on the well being system of ERISA, each for good and for not so good? I imply, it’s definitely one of many issues that makes it so complicated to grasp and clarify. Larry, you need to go first?
Levitt: I feel the largest impression 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, but it surely has actually circumscribed what states can do round well being reform. That mentioned, ERISA has supplied a really secure regulatory setting for employers and certain 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 modern. Not each self-insured employer has been modern, proper? And there’s one thing like one million employers on the market with a thousand or extra workers. And the smaller of these are usually not essentially being modern, however they’re studying from the most important ones, proper? The jumbo employers, who’re attempting to do various things in terms of participating the well being system, proper? Participating hospitals and physicians and pharmaceutical managers.
And I feel that that … the teachings realized from what they’re doing trickles right down to the smaller self-insured employers, and it trickles out to the well being insurers which might be providing totally insured plans to small employers.
Rovner: Ilyse.
Schuman: I feel ERISA has allowed employers to supply 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 taking a look at, 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 puzzled what would emerge from that, and with some dents, but in addition with a whole lot of silver linings when it comes to employers providing advantages to assist their workers navigate by means 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 method of well being protection? I promise I cannot maintain you to it. Simply greatest guess. Larry.
Levitt: I say no.
Rovner: Paul.
Fronstin: I reply “don’t know.”
Rovner:: That’s OK. Ilyse.
Schuman: Nicely, I’ll say that I only recently acquired a tortoise for my household that I’ve discovered will reside 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 a few of the underlying drivers of rising well being care prices and consolidation, I feel that if these are addressed, I feel employer-provided protection definitely has the power to resist the take a look at of time over the subsequent 50 years.
Rovner: Good. Thanks all a lot. This has been nice.
Schuman: Thanks quite a bit.
Levitt: Nice. Thanks, Julie.
Schuman: Thank your group.
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 visitors, 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 challenge 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 alternate 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 Occasions need to hear it. E-mail your expertise to Elisabeth Rosenthal — that’s elisabethr with an S, not a Z — @kff.org. As all the time, in the event you benefit from the podcast, you possibly can subscribe wherever you get your podcasts. We’d respect it in the event you left us a assessment; that helps different folks discover us, too. Particular thanks, as normal, to our technical guru, Francis Ying, and our editor, Emmarie Huetteman. As all the time, you possibly can e-mail us your feedback or questions. We’re at whatthehealth, all one phrase, @kff.org, the place you possibly can 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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