Author Archives: Joanne Kenen

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at She welcomes questions and suggestions on health reform resources and tip sheets at

Services enabling disabled to live more mainstreamed life may fall prey to GOP reforms

Photo: Alexander Edward via Flickr

Medicaid is a lifeline for the disabled. As Jonathan Cohn explains, the current Washington debate over Medicaid’s future has profound and often overlooked implications.

Right now much of the Washington policy fight centers on how quickly – when, but not if – the Medicaid expansion of the Affordable Care Act would get rolled back under Republican repeal-and-replace bills. As we’ve pointed out before, there’s a lot less attention being paid to Republican proposals to cap Medicaid spending – to put an end to its open-ended federal entitlement funding. The Senate Republicans are arguing over what rate the spending would grow (there are a few different ways of measuring inflation and medical inflation….). They are not debating whether or not to make this fundamental change – which the Democrats all oppose. Continue reading

Resources for tracking rural hospital closures

Photo: throgers via Flickr

The phenomenon of rural hospital closures has gotten a fair amount of attention in the last few years with all the Affordable Care Act finger-pointing. But as the University of North Carolina’s Cecil G. Sheps Center notes, the problem really emerged and caught the attention of policymakers in the late 1980s.

For a few years, the U.S. Department of Health and Human Services published an annual report, but closures slowed down about 20 years ago, and interest waned. The pace of closures picked up again during the Great Recession of 2008-09, before the ACA’s passage. Continue reading

Revised HHS rules aim to shift more health plan control to states

Photo: knitsteel via Flickr

Before the Affordable Care Act, health insurance regulation in the individual market largely was managed by the states. The ACA saw a shift to a greater federal role. Now under the Trump administration, some responsibilities are going back to the states.

In a new tip sheet for AHCJ, Louise Norris, whom many AHCJ members know as a contributor to, explains the new responsibilities. One significant area is network adequacy – whether a plan has enough doctors, hospitals and other providers to meet the needs of beneficiaries. Continue reading

Harsh CBO score doesn’t ease the path of Senate Republicans writing their repeal bill

Photo by Sean Stayte via flickr.

If Senate Republicans were hoping that this week’s new CBO score of their revamped House health bill was going to make life easier for them … Not so much.

House leaders had worked hard to revise American Health Care Act when they couldn’t get the votes. But the Congressional Budget Office found that the projected impact of the amended version, which narrowly passed the House in early May, wasn’t all that different than the original.

The old bill would have led to 24 million fewer Americans having coverage in a decade. The new bill, according to CBO, would mean 23 million would not be covered. Continue reading

Budget includes massive cuts to Medicaid beyond AHCA proposal

The Trump administration is doubling down on its goal of reshaping Medicaid financing and sharply reducing spending.

As we’ve noted before, the House version of the American Health Care Act would put a stop to the open-ended entitlement funding of Medicaid. States would either get a per capita cap (a yearly amount per person) or a block grant (a lump sum). The per capita cap would give states more flexibility as the economy cycles through good and bad periods. In slumps, when more people go on Medicaid, the amount would go up. The block grant amounts would rise by a pre-determined amount for 10 years, but states would have more flexibility in program design. Continue reading