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health care

John Krahne received alarming news from his doctor last December. His brain tumors were stable, but his lung tumors had grown noticeably larger.

The doctor recommended a drug called Alecensa, which sells for more than $159,000 a year. Medicare would charge Krahne a $3,200 copay in December, then another $3,200 in January, as a new year of coverage kicked in.

Congressman Paul Ryan of Wisconsin speaking at CPAC 2011 in Washington, D.C.
Flickr Photo/Gage Skidmore (CC BY-SA 2.0)/https://flic.kr/p/cVEJJh

Bill Radke talks to Mary Agnes Carey, senior correspondent for Kaiser Health News, about the American Health Care Act and how it will affect the way people are insured. 

U.S. Senator Patty Murray
Flickr Photo/Senate Democrats (CC-BY-NC-ND)

Bill Radke talks to Senator Patty Murray about the House Republican's American Health Care Act that would repeal and replace the Affordable Care Act. 

A new report finds that the Republican bill to repeal and replace the Affordable Care Act would reduce the federal deficit by $337 billion over a decade but would also leave 24 million more Americans uninsured during that same period.

Washington Insurance Commissioner Mike Kreidler
Flickr photo/Washington State Office of the Insurance Commissioner (CC BY-ND 2.0)/https://flic.kr/p/K52qFP

Republicans are “moving so fast, with so little oversight” that the Obamacare replacement could have major structural problems, said Mike Kreidler, Washington state's insurance commissioner.

“We could actually see market collapse, certainly in the state of Washington, but I predict that that could even be across the country,” Kreidler said.


It took a lot to get to this point, but Republicans have released their long-awaited health care bill. (For more on the policy, check out the NPR health team's reporting over at Shots.)

The version that was released is likely to change as the bill goes through committees, but now that it's released, here are four potential challenges President Trump and Republicans face:

1. Health care is complicated

House Republicans unveiled their long-awaited replacement plan for the Affordable Care Act Monday night. They're calling it the American Health Care Act.

After years of waiting, it's finally here.

Amy Radil

Being a Daffodil Princess in Pierce County is not about winning a pageant. Kelty Pierce, 19, is emphatic on that point.

In recent days, several Republican lawmakers have faced crowds of constituents at town hall meetings around the country who are angry that they may be in danger of losing their health coverage.

At a session in Fremont, Shaine Truscott with SEIU-775 helps train "peacekeepers" for protests.
KUOW photo/David Hyde

In a Fremont conference room, about a dozen people pored over a hand-drawn map of the area around Republican Congressman Dave Reichert's office over in Issaquah. 

This is the specter currently haunting President Donald Trump and Republicans in Congress: a left-wing Tea Party movement – led by paid protesters – that aims to disrupt their Town Halls and other public events across the country.


Mardie Rhodes of Sammamish was one of the people at the rally in Issaquah on Thursday.
KUOW photo/David Hyde

Protesters gathered outside Congressman Dave Reichert's office in Issaquah on Thursday, upset that he hasn’t scheduled face time with the public during the first Congressional recess since Donald Trump was elected president.

KUOW Photo/Kate Walters

Teen birth rates fell by 55 percent in King County between 2008 and 2015, according to officials.

County Executive Dow Constantine credits expanded access to long-lasting birth control and preventive care, as well as greater insurance coverage.

Swedish Hospital's facility on Seattle's First Hill.
Flickr Photo/Matthew Rutledge (CC BY 2.0)

Bill Radke talks to Mike Baker, investigative reporter for The Seattle Times about his investigation into the high volume of surgeries in the neurosurgery department at Swedish's Cherry Hill facility. He documented his findings in a report called "Quality of Care" published in The Seattle Times. 

Neon Sugar
FLICKR PHOTO/Adam Engelhart (CC BY 2.0)/https://flic.kr/p/fqv6q

A friend might try to talk you out of smoking cigarettes or your alcohol consumption, but would they criticize your sugar habit? What if they knew that not long ago scientists were paid to proclaim the dangers of fat when the facts pointed to sugar and carbohydrates?

President Donald Trump shakes hands with 10th U.S. Circuit Court of Appeals Judge Neil Gorsuch, his choice for Supreme Court associate justice in the East Room of the White House in Washington, Tuesday, Jan. 31, 2017.
AP Photo/Carolyn Kaster

How would U.S. Supreme Court nominee Neil Gorsuch handle the case of the Eastern Washington florist who refused to sell wedding flowers to a same-sex couple?

It’s not completely clear, but there are some hints, Slate writer Dahlia Lithwick told KUOW’s David Hyde.

Republican Sen. Chuck Grassley, chairman of the Senate Judiciary Committee, has opened an inquiry into potential abuses of the Orphan Drug Act that may have contributed to high prices on commonly used drugs.

In a statement, Grassley said the inquiry is "based on reporting from Kaiser Health News" and strong consumer concern about high drug prices.

"My staff is meeting with interested groups and other Senate staff to get their views on the extent of the problem and how we might fix it," Grassley wrote.

Seattle & King County Public Health Officer Dr. Jeff Duchin
KUOW Photo/Katherine Banwell

Emily Fox speaks with Dr. Jeff Duchin, public health officer for Public Health-Seattle and King County, about how ending the Affordable Care Act will impact people of color.

There's a moment in the Broadway musical Hamilton where George Washington says to an exasperated Alexander Hamilton: "Winning is easy, young man. Governing's harder."

When it comes to health care, it seems that President Trump is learning that same lesson. Trump and Republicans in Congress are struggling with how to keep their double-edged campaign promise — to repeal Obamacare without leaving millions of people without health insurance.

Adams County had the highest use rate of the state exchange at 50 percent.
Courtesy of 1in4WA.com

As Congress looks at changes to the Affordable Care Act, the creators of Washington’s health insurance exchange are advocating for the state’s current system – with maps.

Those maps show where the exchange has had the greatest rate of participation in the state: Trump country.


Before they get to work on reforming the U.S. Department of Veterans Affairs, Congress and the White House might want to take a closer look at the last time they tried it — a $16 billion fix called the Veterans Choice and Accountability Act of 2014, designed to get veterans medical care more quickly.

It's the last day to sign up for health insurance under the Affordable Care Act.

And at Whitman-Walker Health, a community health center near downtown Washington, D.C., people have been streaming in looking for help choosing an insurance plan.

Katie Nicol is a senior manager who oversees the five so-called navigators whose sole job is to help people sign up for insurance coverage.

Community health leaders like Teresita Batayola of ICHS worry about the future of ACA.
Courtesy of ICHS

The deadline to sign up for health coverage is coming up at the end of the month. So far, more Americans have enrolled for health insurance this year than in previous years. At the same time, Congress has taken steps to repeal the Affordable Care Act.


As promised, President Trump has moved to dismantle the Affordable Care Act. It's a concern for those who might be left without health insurance — and especially for the Department of Veterans Affairs, which may have to pick up some of the slack.

Carrie Farmer, a health policy researcher at the Rand Corp., says 3 million vets who are enrolled in the VA usually get their health care elsewhere — from their employer, or maybe from Obamacare exchanges. If those options go away, she has no idea just how many of those 3 million veterans will move over to the VA.

Washington Insurance Commissioner Mike Kreidler
Flickr photo/Washington State Office of the Insurance Commissioner (CC BY-ND 2.0)/https://flic.kr/p/K52qFP

State Insurance Commissioner Mike Kreidler estimates one million people in Washington have received health care coverage under the Affordable Care Act, also called Obamacare.

He told KUOW's Ross Reynolds that without a plan in place from Republicans in Congress, those people could all lose insurance if Obamacare is repealed.


Amy Knickrehm of Seattle told reporters at a news conference Monday that her chronic pain and depression went undiagnosed for years because she had no health care.
KUOW Photo/Patricia Murphy

King County Executive Dow Constantine said he’ll fight to keep affordable health care for people currently covered under Obamacare. 

Constantine held a news conference with Public Health officials, local providers and patients three days after President Donald Trump signed an executive order that begins the processes of rolling back the Affordable Care Act. 


Donald Trump will be inaugurated as the 45th president on Friday in Washington. He opened the week by calling out Rep.

Author Daniel Dawes.
Brigitte Martin Mack

The Affordable Care Act will be seven years old this March if President-elect Trump and the Republican Congress haven't repealed it by then. 

The Affordable Care Act brought the rate of uninsured Americans to a record low 9 percent in 2015. It's the major achievement of the controversial health care law and one the Obama administration likes to tout whenever it can.

Health and Human Services Secretary Sylvia Burwell did just that in an interview with NPR on Tuesday.

The outcome of the repeal-and-replace Obamacare debate could affect more than you might think, depending on just how the GOP congressional majority pursues its goal.

Beyond the Affordable Care Act's marquee achievements like guaranteeing health coverage for people with pre-existing conditions and allowing children to stay on parents' plans until age 26, the roughly 2,000-page law created a host of other provisions that affect the health of nearly every American.

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