Health insurance in the U.S. is notoriously confusing. So we’re covering the basics to make navigating your plan a little easier. We explain the difference between a deductible and an out-of-pocket limit, define copay and coinsurance, and point out where surprise bills can get you in trouble, from out-of-network providers to prior authorizations. 

Read more coverage from our “Bill of the Month,” “Health Care Helpline,” and “Priced Out” series:

• “How To Make a High-Deductible Health Plan Work for You,” by Jackie Fortiér.
• “To Avoid Care Disruptions, Know When the Clock Runs Out on Your Prior Authorization,” by Sarah Boden.
• “So Your Insurance Dropped Your Doctor. Now What?” by Bram Sable-Smith.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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When Gavin Newsom ran for California governor in 2018, his support for a state-run single-payer healthcare system was considered a risky move and earned him hefty labor endorsements.

Today, leading Democrats in the wide-open race to succeed Newsom have embraced single-payer as a political necessity, an answer to voters fed up with rising premiums and other spiraling healthcare costs.

But with no clear front-runner, they are sparring among themselves in debates and political ads over who is most committed to a government-run model. No candidate has outlined how California would fund comprehensive health coverage for its 40 million residents, leaving voters unable to discern which candidate has a concrete plan for the nation’s most populous state.

Healthcare and political experts said the concept of single-payer has shifted from progressive pipe dream a decade ago to today’s mainstream talking points in a state where Democrats outnumber Republicans nearly 2 to 1. Democrats have pledged the model as the best way to lower costs in an attempt to woo voters worried about affordability as ballots arrive for the June 2 primary. The top two Republicans, meanwhile, have dismissed government-run healthcare as a “disaster” and “socialism.”

“In many ways, single-payer healthcare has become a progressive litmus test,” said Larry Levitt, a former White House policy adviser and a healthcare expert at KFF, a health information nonprofit that includes KFF Health News.

Few voters fully understand the term single-payer, let alone expect the next governor to achieve it, Levitt said. Rather, he added, the term has become more of a signal to voters about a candidate’s approach to healthcare reform.

Xavier Becerra, the former U.S. Health and Human Services secretary, who for decades backed single-payer healthcare in Congress, has come under criticism from opponents for a nuanced but clear shift away from single-payer. It came after Becerra secured an endorsement from the California Medical Association, a powerful group representing doctors and a longtime opponent of single-payer healthcare bills in California.

At a May 5 debate put on by CNN, Becerra declared his support for “Medicare for All,” a proposal for a federally run system that’s been stalled for years, but he declined to say whether he’d pursue a California-led effort. He said his immediate focus would be on mitigating the drastic federal cuts expected to hit low-income and disabled enrollees in Medi-Cal, the state’s Medicaid program, which covers more than a third of residents.

Becerra is counting on voters not to distinguish between the often-confused terms single-payer, Medicare for All, and universal coverage, noting during the debate that “Californians don’t care what you call it, so long as they have affordable healthcare.”

“A lot of people aren’t clear what single-payer is, and they need a metaphor to understand it,” said Celinda Lake, a Democratic strategist and one of the lead pollsters for former President Joe Biden’s 2020 campaign.

Billionaire activist Tom Steyer, who’s touted his self-funding as a signal he can’t be bought, has emerged as the race’s most vocal advocate of single-payer after opposing it during a short-lived 2020 presidential bid.

As governor, Steyer has said, he would pass legislation backed by the California Nurses Association that has failed to come to fruition under Newsom’s tenure. Pressed on how he would cover the estimated $731.4 billion cost, Steyer told KFF Health News that “God is going to be in the details.”

At a forum last year, former U.S. Rep. Katie Porter said she didn’t believe achieving such a system was realistic in the near term, but the Orange County Democrat later told party delegates that she would “deliver single-payer.” Former Los Angeles Mayor Antonio Villaraigosa and San Jose Mayor Matt Mahan, Democrats who are trailing their competitors in the polls, don’t support single-payer. The top two vote-getters — regardless of party — advance to the November general election.

Some of the most seasoned politicians have failed to deliver single-payer. Newsom, who campaigned on the promise of being a “healthcare governor,” dialed back his ambitions upon taking office, choosing instead to pursue “universal access” to health coverage under a series of Medi-Cal expansions and efforts to contain healthcare spending.

The campaign bus for billionaire activist Tom Steyer, who has made single-payer healthcare a central pillar of his run for governor, in downtown Oakland, California. In 2020, Steyer ran for president opposing single-payer healthcare. (Christine Mai-Duc/KFF Health News)

Vermont, which remains the only state to pass a single-payer healthcare law, reversed course when leaders there couldn’t identify a funding source.

To enact single-payer, California would need permission from the federal government to redirect billions of dollars from Medicaid, Medicare, and other funding that currently flows to the system — approval not likely to come from the Trump administration.

More than half of adults nationally say healthcare costs will have a major impact on whom they vote for in November, according an April KFF poll.

Danielle Cendejas, a Los Angeles-based Democratic consultant who works with state legislative candidates, said single-payer healthcare increasingly appears on candidate questionnaires from small-business advocates as well as hyperlocal Democratic clubs, in state legislative races and national union endorsements.

What most California voters want to hear, Cendejas said, is how candidates plan to give them more immediate relief from higher premiums, expensive drug costs, and long waits to access care.

The high price tag doesn’t faze Jennifer Easton, a 63-year-old Democrat from Oakland, who said other countries with similar models have proved they can lower costs. She said she supports a single-payer health system because it’s clear to her that Americans have reached the limits of working within the existing system. But she isn’t expecting any of the current candidates to succeed in implementing one, and she hasn’t decided whom to support.

“No one can in four years,” she said. Seeing a candidate enthusiastically support the concept gives her a good idea of their philosophy. “It is, if we’re lucky, a 20-year, 25-year plan.”

Rob Stutzman, a Republican political consultant who advised former Gov. Arnold Schwarzenegger, said while Americans may be supportive of single-payer in polls, focus groups suggest that approval drops quickly when voters realize it could mean losing their current doctor or insurance plan.

At the CNN debate, Steve Hilton, the Republican candidate President Donald Trump has endorsed, said Californians would end up with subpar patient care and “taxes sky high to pay for it,” like in his native United Kingdom.

Instead, Hilton suggested the state stop providing “free healthcare for illegal immigrants who shouldn’t even be in the country in the first place.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Since his second term started, President Donald Trump has announced, negotiated, or floated a flurry of initiatives aimed at taming the excesses of the pharmaceutical industry.

No surprise. About 60% of American adults are “worried about being able to afford prescription drug costs for themselves or their families,” a recent KFF nationwide poll showed. More than 80% consider the price of prescription drugs “unreasonable,” and most support increased regulation to lower costs. Americans pay about three times as much as people in other countries for the same prescription drugs.

Last July, Trump sent letters to 17 drugmakers, demanding they voluntarily lower drug prices. Then the president said he’d negotiated with more than a dozen pharmaceutical executives one by one at the White House. In December, he announced that he had compelled them to agree to “most favored nation” pricing on Medicaid, the government coverage for low-income Americans.

Then came the unveiling of TrumpRx, a site where cash-paying patients could find discounted medicines, and a promise to speed biosimilar products — generic versions of certain high-priced specialty drugs — by cutting through FDA red tape.

The scope of these grand gestures remains uncertain. But it’s certainly less than what the announcement promised, partly because many details of the negotiations, even which drugs are covered, are hazy.

White House spokesperson Kush Desai did not answer queries about TrumpRx.

Medicaid already buys drugs at deep discounts. And other patients may well have better options through commercial drug discount programs, which offer far more products, or through their insurance and associated drug company copayment cards.

So, for all Trump’s showmanship, the share of Americans likely to benefit from these options remains slim, even if some people do come out ahead.

“If it makes a difference to any patient, it’s a win,” said Mark Cuban, a billionaire investor on his own mission to bring down drug prices. He pointed to discounted pricing on TrumpRx for branded fertility drugs and GLP-1 weight loss drugs for people without insurance or whose plans don’t include coverage. Cuban launched the Mark Cuban Cost Plus Drug Co., known as Cost Plus Drugs, in 2022 to sell drugs cheaply by eliminating middlemen — buying from factories and selling directly to consumers. Most of the drugs he sells are generics.

Aaron Kesselheim, a professor of medicine at Harvard Medical School whose research focuses on drug prices, said the Trump announcements are “one-off agreements made for publicity purposes. They don’t change anything about the way drugs are priced.”

He added: “The agreements are opaque and unenforceable.”

It was unclear, for example, which drugs would be sold at “most favored nation” prices or how exactly that was defined. But, clearly, not all were.

Doing the Math

46brooklyn, a consulting firm and data project that tracks brand-name drug prices, found that close to 1,000 brand drugs went up in price in January 2026. What’s more, 2025 had the highest number of list price increases ever. “This is not a material change, it’s business as usual,” said Antonio Ciaccia, the company’s co-founder.

In the first week of 2026, Pfizer raised the list prices of 71 drugs by an average of 5% and lowered the price of only one, by 9.8%, the data project found.

The biggest win for patients has likely been the Trump administration’s quiet continuation of a Biden administration program: Medicare drug price negotiation for expensive drugs. The negotiated discounts on the initial 10 drugs — from blood thinners to insulins to medicines for inflammatory disorders — went into effect Jan. 1. With reductions in price of well over 50% on some products, the estimated $6 billion in annual savings allowed the program to cap Medicare patients’ out-of-pocket spending on Part D prescription drugs at $2,000 for 2025 and beyond.

An additional 15 high-priced drugs — including popular weight loss and cancer drugs — were subject to negotiation in 2025, with discounted Medicare prices taking effect next year. And 15 more high-priced drugs are set for negotiation this year. All told, the 40 negotiated drug prices are expected to save Medicare well over $20 billion a year.

Even as these discounts take effect, drug industry lobbyists have been working to limit the impact, with some success. For example, the One Big Beautiful Bill Act exempts drugs for rare diseases from negotiations.

Still, “this is historic because it’s the first time the United States has negotiated prices, like every other developed country,” Kesselheim said. “And guess what? Innovation didn’t stop.”

Of course, these discounts benefit only Medicare enrollees. The newer Trump administration initiatives help some other patients, but they are limited and require knowledge of how to access the discounts.

Trump’s One-on-Ones

The president’s televised appearances with the heads of major drug companies resulted in deals, but few, if any, will mean much to patients. For example, after Trump met with Albert Bourla, CEO of Pfizer, the company announced discounts on 30-plus drugs. Bourla called the deal “a win for American patients, a win for American leadership, and a win for Pfizer.”

The discounts are offered via TrumpRx, which, in turn, offer coupons co-branded on GoodRx.com, which already offers discount coupons for many hundreds of medicines.

Pfizer made hay of the deal, announcing it was part of Pfizer’s broader, landmark most favored nation, or MFN, agreement with the U.S. government, enabling patients to pay lower prices for their prescription medicines “while strengthening America’s role as the global leader in biopharmaceutical innovation.”

Pfizer spokesperson Steven Danehy cited a press release from September noting that the TrumpRx site offers patients savings that “range as high as 85%.”

Most of the list features brand-name drugs, competing with far cheaper generic versions from other manufacturers, such as the cholesterol-lowering drug Colestid, which TrumpRx lists for “50% off” at $127.91. Generic versions cost about $17 on the Cost Plus site.

This means the branded companies aren’t making a sacrifice by offering them at lower costs as reflected on Trump’s portal, said Sean Tu, a patent law expert at the University of Alabama. “That’s a sale they would not have made if not for TrumpRx.”

Others are very old drugs, such as Cortef, or hydrocortisone, whose 5-milligram branded Pfizer version is listed at $45 on TrumpRx, half its list price of $91.80. It sells for far less on Cuban’s Cost Plus site. Still others, such as the $607.20 HIV treatment Viracept, are useful only in combination with other drugs that are not discounted.

Last week, TrumpRx added Amgen’s Humira, for years the world’s best-selling drug, at $950 a dose, down from a list price of nearly $7,000. But Humira lost its patent protection in 2023, and biosimilars — essentially generic equivalents — have since come to market. More to the point, two of those biosimilars are listed on TrumpRx for as little as $207.60 a dose.

Since most of the TrumpRx products are available only to customers without insurance who pay cash, the arthritis drug Xeljanz’s drop from $2,277 to $1,518 a month would still leave it unaffordable.

A Few Notable Deals

The much-touted TrumpRx site, launched Feb. 6, consists largely of Pfizer’s 30 drugs (30 of roughly 85) with a smattering of discounts likely to generate headlines.

These include three fertility drugs from EMD Serono, a subsidiary of the pharmaceutical giant Merck KGaA, the most expensive of which, Gonal-F, has a list price of $966 but is only $168 per IVF cycle using a TrumpRx coupon.

They will save women thousands of dollars — although the overall cost of fertility treatment will continue to put them beyond the reach of many, since drugs represent only a portion of the payment.

The TrumpRx discounts could reduce the $15,000-to-$25,000 cost of a single fertility treatment cycle — women typically need two or three cycles to become pregnant — by about 10%, said Sean Tipton, spokesperson for the American Society for Reproductive Medicine. In some European countries, each cycle costs about $3,000.

In exchange for lowering those prices, EMD Serono got tariffs lifted on its mostly overseas-produced medications. It also won the right to a sped-up FDA approval process for a fertility drug it’s been marketing heavily in Europe.

Another newsworthy offering on the site resulted from a deal with Novo Nordisk for Wegovy, its GLP-1 drug for weight loss and diabetes, with the price reduced to as little as $199 a month for the pen. (Many insurers cover such drugs only for diabetes, leaving those who are interested in losing weight paying out-of-pocket. Zepbound, Wegovy’s Lilly & Co. competitor, is also on the list, at $299.)

Pressure has been building on Novo and Lilly to lower the U.S. price of their GLP-1 drugs. The compounds have lost patent protection in India, and pressure from customers buying overseas will likely increase when generic Wegovy goes on sale in Canada, for as low as $73 a month, possibly this year.

In the United States, meanwhile, dozens of patents should keep Wegovy generics off the market until 2039, said professor Robin Feldman, a patent expert at the University of California Law-San Francisco. A recent report from the research group I-Mak delved into several ways patent manipulation keeps generics off the U.S. market long after they are available in European countries and Canada.

And while the Trump administration has vowed to approve biosimilars more rapidly to ensure more competition and lower prices, that may not have much impact. The big hurdle in getting generics and biosimilars to market is often not FDA approval, but the time it takes to override the thickets of patents that U.S. law allows manufacturers to deploy to protect their intellectual property.

For example, in 2021, the FDA approved a generic of Otezla, a popular drug for psoriatic arthritis, but it will not hit the market until 2028. Its entry would require drugmakers to pay rebates to Medicare if they charged the program more than other developed countries for “single source” drugs and biologics. That would essentially allow the Medicare program to piggyback on other countries that negotiate the prices of some of the most expensive medicines. Those programs are still going through the rulemaking process and, again, would benefit only those covered by the Medicare program and only indirectly.

The average patient-consumer, if willing to pay cash, may find some bargains. But getting the best deal could take a lot of mixing and matching, forcing patients to become choosy shoppers, eyeing deals for essential medicines as they would for a carton of milk or eggs.

Data reporter Maia Rosenfeld contributed to this article.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Starting in July, Medicare beneficiaries may be able to get a GLP-1 prescription for weight loss for $50 a month. It’s a notable shift for Medicare, which has long been barred from covering weight loss treatments.

The drugs, such as Wegovy and Zepbound, are effective but can be expensive without insurance coverage. They’re available in injection or pill form. Even with discounts, current cash prices typically range from $149 to $699 per month.

About half of GLP-1 users say these drugs were difficult for them to afford, according to KFF polling. A quarter said they were “very difficult” to afford.

But the new Medicare benefit comes with caveats, particularly around clinical guidelines and what happens when the short-term program ends.

What Is This Program?

The initiative, announced by the Centers for Medicare & Medicaid Services, is a short-term pilot program known as the Medicare GLP-1 Bridge. It will run from July 1, 2026, through Dec. 31, 2027. It’s meant to “bridge” the gap before a longer-term program that might — or might not — begin in 2028.

The pilot program will offer coverage for the following GLP-1 medications approved for weight loss: the pill and injectable formulations of Wegovy, the KwikPen formulation of Zepbound, and the Foundayo pill.

Who Can Participate?

To get access to these weight loss medications, you must be enrolled in a Medicare Part D plan, which covers prescription drugs. After that, eligibility is based mainly on body weight and health status. People will qualify if they have a body mass index of 27 or higher and have a condition such as heart disease or prediabetes, among others. People with BMIs of 35 or higher automatically qualify. About 40% of American adults are clinically obese, with a BMI of 30 or higher, according to the Centers for Disease Control and Prevention.

How the Program Works (It’s a Bit Unusual)

This is not your typical Medicare benefit. Even though Part D enrollment is required, the Bridge program itself works differently.

Instead of going through your regular Part D plan, you will need prior authorization. Your doctor will send the prescription to a central system run by CMS contractor Humana, using a system already in place for another Medicare drug program. Doctors don’t need to be enrolled as Medicare providers to write a prescription or submit a prior authorization request under this program. Once they get approval, patients will pay the flat $50 copayment at the pharmacy when they pick up the prescription.

What Are the Benefits?

The cost savings could make these drugs accessible to patients who simply couldn’t afford them before. Even with discounts, the prices can be daunting without insurance coverage. TrumpRx, a new government website, provides links to direct-to-consumer prescription drug discounts for patients not using their health insurance. On that site, Wegovy injectables range in price from $199 for a lower dosage for the first two months to $399 for a higher dosage. The KwikPen formulation of Zepbound costs up to $699 per month. At the highest dosages, the daily Wegovy pill costs up to $299 while Foundayo tops out at $349.

Most people who use these drugs will need a higher dose to maintain weight loss. The Bridge program is unique in that it offers a predictable $50 copayment that does not go up as dosages increase.

What Are the Downsides?

Like many pilot programs, there are trade-offs. The $50 copay will not count toward the Part D deductible, nor does it count toward the $2,100 annual out-of-pocket cap on prescription drug costs. The pilot program will also end in December 2027. Most studies have shown that many people who stop using the GLP-1 drugs regain weight they lost while taking them.

Still Obstacles for Those With Low Incomes

If you receive the low-income subsidy, also known as the Medicare Extra Help program, you cannot use that assistance for the drugs covered by the GLP-1 Bridge program. For beneficiaries accustomed to paying a $5 or $10 copay for their pharmaceuticals, a $50 copay could still be a big financial barrier.

“Fifty dollars a month sounds like a great deal compared to paying the discounted prices through TrumpRx and these other direct-to-consumer options, but it’s a lot of money for somebody who’s living on a $750-a-month Social Security check,” said Juliette Cubanski, deputy director of the Program on Medicare Policy at KFF, a health information nonprofit that includes KFF Health News.

The $50 Copay Is Only for Weight Loss

If you’re already taking one of these medications for a qualifying condition such as Type 2 diabetes, cardiovascular disease risk reduction, or sleep apnea, you’ll continue to get it through your regular Part D plan. That means you’ll pay your plan’s price, which may be higher than the $50 Bridge copay, meaning the same drug could cost different amounts depending on the reason it is prescribed.

If you’re already on a GLP-1 for weight loss, you may qualify for the Bridge program. Your prescriber will need to attest that you met the clinical criteria when you first started the medication. For example, if you started a GLP-1 in September 2024 with a BMI of 37 but in July 2026 you’ve lost weight and now have a BMI of 34, the prescriber should attest in the prior authorization request that you met the BMI criteria of 35 or over when the GLP-1 therapy started.

What Happens After 2027?

The Trump administration had proposed a two-step approach to expand coverage of GLP-1s for obesity in Medicare. The Bridge program was initially planned to last six months — after that, the idea was to launch a longer-term program that would shift the cost of the drugs from the government to insurers. A recent study found the long-term program would have cost insurance companies billions of dollars in the first year. Not enough insurers signed on for the voluntary plan by the April deadline, so CMS instead announced it would extend the Bridge program to 18 months, with a new end date of December 2027.

The move will give insurance companies more data on how many people with Medicare get GLP-1 drugs during the Bridge program and more time to negotiate with the Trump administration.

But extending the Bridge program will be “really expensive” for Medicare, Cubanski said, because the program heavily subsidizes the cost of the drugs.

“There’s no sense right now of the cost of the Bridge model, but it is likely to be billions of dollars a year in additional spending for Medicare,” Cubanski said.

The cost to Medicare will depend largely on how many people use the Bridge program. CMS has not provided any projections publicly, but a previous KFF analysis estimated that in 2020 close to 14 million Medicare beneficiaries were overweight or obese.

“This will just cost additional money, and we don’t know how much, because they haven’t disclosed it,” Cubanski said.

Are you on Medicare and interested in getting a GLP-1 for weight loss? Is a $50 copay manageable? Click here to contact KFF Health News’ reporting team.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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SACRAMENTO, Calif. — In his earliest days in the governor’s office, Democrat Gavin Newsom huddled with his advisers to consider how to realize a key campaign promise: transforming a healthcare system replete with insurance company intermediaries into the nation’s first state-run single-payer model providing comprehensive coverage to all residents, similar to those in Canada and Taiwan.

He’d need to secure tax increases to help cover the high cost of a single-payer system, once pegged at about $500 billion a year, and Republican President Donald Trump, then in his first term, would have to give California permission to use federal funding to convert the system of coverage from one determined by employment, age, or income.

Neither was politically feasible.

Instead, in the years that followed, Newsom muscled through a compassionate healthcare agenda that poured billions into new benefits, including Medi-Cal coverage for low-income immigrants without legal status and incarcerated people leaving jail or prison, as well as programs for people experiencing homelessness in America’s richest and most populous state. Medi-Cal, the state’s Medicaid program, now includes housing services, including six months of free rent for those in need, and home-delivered healthy meals for low-income Californians with chronic health conditions. He made it a priority to expand mental health and addiction treatment, especially for the tens of thousands living on the streets.

He also tackled the soaring cost of healthcare, including by offering bigger subsidies for low- and middle-income earners to purchase insurance and empowering a new state agency to slow the rise in healthcare spending. Years before TrumpRx, the president’s program to lower prices for some medicines for people without insurance, Newsom signed into law a policy setting up a state-branded generic prescription drug label known as CalRx to provide lower-priced drugs. And amid a federal attack on reproductive rights, Newsom led efforts to safeguard abortion.

The liberal values that guided Newsom’s healthcare ambitions were forged early in his life and cultivated during his two terms as mayor of San Francisco. His approach in the governor’s office is described by allies as socially liberal and fiscally pragmatic. The policies he has supported offer a road map for the direction he would lead the nation, should he run for and be elected president in 2028. Now in his final term as governor, Newsom will be scrutinized for his healthcare record, criticized by liberals as too moderate and by Republicans as too radical.

Newsom, 58, is known for his all-out approach, a style that leads him to take on a barrage of flashy and complicated policy proposals at once, earning him a reputation in some political circles of overpromising and underdelivering. Newsom has notched some successes, but his record is also marked by failures. He hasn’t housed as many people as he envisioned — there are nearly 190,000 homeless people in California, according to the most recent federal estimates, more than when he became governor. Medicaid spending has more than doubled under his watch, drawing criticism from Republicans, and patients around the state are experiencing problems getting timely medical appointments and quality care.

Newsom’s closest allies argue that he has balanced efforts to make healthcare more equitable, accessible, and affordable. They argue his unmet policy goals are not failures but investments and long-term strategies to better serve poor and marginalized people while containing healthcare costs.

“We would talk about how you win by losing,” said Mark Ghaly, who served as Newsom’s health and human services secretary until 2024. “The governor isn’t afraid to fail. But by failing you learn about how to make it successful.”

Although voters in the Democratic stronghold of California have supported many of his ideas, residents have grown increasingly weary in their support. An early 2026 poll from the University of California-Berkeley Institute of Governmental Studies showed Newsom’s job approval slipping as he has focused on attacking Trump on the national stage.

Rising costs have become a top concern for voters across the political spectrum. Two-thirds of the public in January said they worried about being able to afford healthcare for themselves and their families, according to a KFF national survey. And a recent Gallup poll found roughly a third of adults in America have made at least one trade-off to afford healthcare, such as driving less, skipping meals, cutting utility use, rationing prescriptions, or borrowing money.

Despite the criticisms, Newsom’s extensive record on healthcare can give him an edge in a presidential primary contest, said Celinda Lake, a national Democratic strategist who specializes in healthcare polling. “Newsom has, by far, the most comprehensive and authentic agenda of any Democrat out there,” she said.

Universal Healthcare

Newsom has said that healthcare should be a basic human right, not a privilege. Though he backed away from single-payer, he remains steadfast in his support for a universal healthcare system that covers everybody, regardless of immigration status or ability to pay.

When he was mayor of San Francisco, in 2006, he signed into law Healthy San Francisco, a universal health program that extended care to all uninsured adults who had been unable to access coverage. The program, paid for through a combination of public funds, employer contributions, and a sliding fee scale for patients based on income, became immensely popular, extending care to 85% of adults who had been uninsured.

Newsom also waded into the national healthcare debate leading up to the enactment of the Affordable Care Act, pushing for a government-run insurance plan to compete with commercial health insurers. “Healthcare reform without a public option is not reform,” Newsom said in 2009.

In 2017, amid his two terms as lieutenant governor, Newsom had launched his run for governor and gained momentum by making healthcare a central pillar of his campaign. During the gubernatorial primary, he said healthcare “is the issue of our time.” He set himself apart by tacking left and earned a critical endorsement from the California Nurses Association, pledging to fight for single-payer.

“It’s time for a new approach,” Newsom said during his campaign. “I’m tired of politicians saying they support single-payer but that it’s too soon, too expensive, or someone else’s problem.”

On his first day in office, he signed a series of directives to explore the feasibility of single-payer, in part by seeking federal healthcare waivers that would be needed to fund a new system. He didn’t deliver, but advisers argued he mimicked some components of single-payer, including cost containment, comprehensive benefits, and universal coverage.

“He looks much more broadly at the healthcare system, and what it can do to help people,” said Newsom Deputy Cabinet Secretary Richard Figueroa. “There is also a role for the government to play in cost containment. The governor has been trying to set up some fundamental changes to move toward a more accountable healthcare system.”

The nurses union, however, blasted Newsom for backtracking, arguing he kept the profit-driven insurance system intact and failed to deliver a critical healthcare promise.

Jasmine Ruddy, director of the National Nurses United and California Nurses Association’s community and Medicare for All campaigns, said Newsom pulled a bait and switch on Californians, purposely mixing up universal healthcare with single-payer. She pointed to a report commissioned by the Newsom administration that found single-payer could increase taxes but, in one scenario, would save an estimated $16 billion the first year in state healthcare costs.

“Covering everyone is important, but Newsom is supporting a system that still has insurance premiums, deductibles, and copays,” Ruddy said. “And you can still wind up with an enormous hospital bill and medical debt. That is not the same as guaranteeing healthcare for all.”

The pressure is already building for Newsom to get behind single-payer — at home and nationally. Ruddy said, “If he runs for president as a progressive, he has no choice but to support Medicare for all.”

A Behavioral Health Crisis

Newsom has taken an ambitious approach to homelessness, framing it as a public health crisis fueled by a lack of affordable housing and inadequate mental health and addiction care. Arguing that the state had ignored the problem for too long, he took ownership of the challenge by increasing temporary funding for cities and counties to move people off the streets and into housing. At the same time, he called for a statewide push to dislodge homeless encampments.

Although his policies rankled homeless advocates by sweeping people from their encampments without providing enough services or housing, Newsom considers it his highest calling. “The junction of mental illness, drug addiction, and homelessness was why I had even pursued a life in politics in the first place,” he wrote in his memoir, Young Man in a Hurry, published in February.

Since Newsom took office in 2019, California has doled out an unprecedented $37 billion for homelessness and housing-related programs.

His interest in mental health and addiction, he said, stems from personal experience, and seeing that it touches so many Californians. “It’s not just about what’s happening on the streets and sidewalks; it’s what’s happening behind closed doors as well,” Newsom said in response to a question from KFF Health News in March. He referenced his grandfather, saying, “He ultimately took his life, committed suicide.”

In his memoir, Newsom alludes to those family issues. He also references his drinking as mayor of San Francisco, a time when his political celebrity was rising and he had an affair with the wife of his campaign manager. Although he never went to traditional rehab, he said he stopped drinking until a family friend who operated a rehabilitation center gave him permission to drink again. For all his investments in the healthcare safety net, Newsom’s critics say his policies have weakened access to basic care and failed to solve homelessness.

“Despite all that spending, there are still so many people who can’t even get in to see a doctor, and who might be covered on paper but aren’t able to actually get the care they need,” said Rep. Kevin Kiley, a Republican-turned-independent who is running in a newly drawn House seat and served in the Democratic-controlled state legislature earlier in Newsom’s tenure as governor. “Billions of dollars have gone to immigrants, when our own citizens haven’t had access to healthcare.”

Assembly member David Tangipa, a Fresno Republican, said Newsom is bankrupting the state, referring to ballooning costs in Medi-Cal, which have grown from $100.7 billion in 2019 to $222.4 billion for the fiscal year starting July 1. “It’s baffling to see this governor attacking the president, when we have our own problems: Doctors are leaving this state, and we have hospitals on the verge of collapse,” he said.

Newsom’s healthcare record could be a political liability. “Single-payer is a perfect example of Gavin Newsom — that when things get tough, he cuts and runs,” said Lanhee Chen, a health policy fellow at the conservative-leaning Hoover Institution.

Now in his final full year in office, Newsom is confronting massive fiscal challenges.

Recent state financial deficits, worsened by the healthcare cuts in congressional Republicans’ One Big Beautiful Bill Act, have forced Newsom to partially backtrack on his expansion, particularly of Medi-Cal. This year, he froze new enrollments for adult immigrants living in the country without authorization.

Yet he is still framing his healthcare record as one of success. In an interview with Axios, Newsom proclaimed that he had achieved universal healthcare. “We delivered it,” he said.

But California does not have universal healthcare. Before passage of the One Big Beautiful Bill Act, estimates showed nearly 2.6 million Californians were uninsured, including people who chose to forgo coverage and immigrants without legal status who earned too much money to be eligible for Medi-Cal.

Projections in 2025 showed that 6% of Californians remained uninsured, lower than the roughly 8% when Newsom took office. Yet the number of uninsured residents is expected to climb as a result of Trump administration healthcare policies. Estimates show the GOP bill will cost the state an estimated $30 billion over the next 10 years and result in up to 3.4 million Californians losing coverage.

Even so, Newsom has been reluctant to raise taxes. He opposes one to backfill federal healthcare funding losses through a one-time 5% levy on the state’s more than 200 billionaires.

“That’s not what we need right now, at a time of so much uncertainty,” Newsom said. “Quite the contrary.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Schmeeka Simpson of Omaha works as a patient navigator for the American Civil Liberties Union and an administrative assistant at Nebraskans for Peace, plus picks up shifts at a Dunkin’ shop.

Still, even with three jobs, she worries about losing her health coverage when Nebraska, on May 1, becomes the first state to require certain Medicaid enrollees to work, train, or go to school under a rule mandated by congressional Republicans’ One Big Beautiful Bill Act.

Simpson, 46, has relied on Medicaid since her divorce in 2014. None of her employers offers health coverage. She said she lost her government food assistance after technical problems caused her to miss renewing in time, and she doesn’t trust the state to implement the new work rules without problems.

“Adding more barriers won’t make the program work any better,” she said.

Even though she works three jobs, Schmeeka Simpson worries about losing her health coverage when Nebraska becomes the first state to require certain Medicaid enrollees to work, train, or go to school under a new federal mandate. (Schmeeka Simpson)

Nebraska Medicaid officials say they are trying to make it as easy as possible for enrollees to comply, so people don’t lose their coverage for administrative reasons, such as failing to file the proper paperwork.

Enrollees with one of thousands of health conditions detailed by the state would be exempt.

“Our top priority is making sure members clearly understand changes to the program and how to maintain their coverage,” Drew Gonshorowski, the state’s Medicaid director, said in an early-April news release.

In a brief interview with KFF Health News on April 28 outside the National Press Club in Washington, D.C., Centers for Medicare & Medicaid Services Administrator Mehmet Oz said he applauds Nebraska for being the first state to begin implementing the work requirements. He acknowledged that the state is still “working out the kinks,” adding that his hope is “by the end of this year they will get into a more sophisticated place.”

But health policy analysts, advocates for the poor, and health industry groups remain skeptical, fearing thousands of Nebraska Medicaid enrollees will lose coverage and, with it, their access to health services and protection from medical debt.

Hospitals also worry an increase in uninsured patients will hurt their bottom lines, said Jeremy Nordquist, the president and CEO of the Nebraska Hospital Association.

“There is a lot of concern on many different levels,” he said. Many enrollees are unaware of the changes and might not realize they have to act to stay insured, he said.

The bill President Donald Trump signed last July requires the 42 states, along with the District of Columbia, that fully or partially expanded Medicaid under the 2010 Affordable Care Act to implement a work requirement starting in 2027. The full expansion enables adults with incomes of up to 138% of the federal poverty level — amounting to $22,025 for a single person this year — to be eligible for Medicaid, the government program covering people with low incomes or disabilities.

More than 20 million people gained coverage from Medicaid through expansion, according to KFF, a health information nonprofit that includes KFF Health News. The Congressional Budget Office estimates 4.8 million will become uninsured over the next decade as a result of the work requirement.

Under the law, enrollees must work or volunteer at least 80 hours a month, attend school at least part-time, or participate in job training. Or they must prove they qualify for certain exemptions, such as caring for a child 13 or younger or a disabled parent, or having a health condition that prevents employment.

Some states explored implementing work rules in the years before the GOP law passed. It gave states the option to launch their programs early.

Nebraska’s Plan

In Nebraska, which is implementing the provision eight months before the law requires, about 70,000 Medicaid enrollees will need to meet the requirement, said Collin Spilinek, a spokesperson for the Nebraska Department of Health and Human Services.

About 72% of them probably won’t have to do anything to keep their coverage, because the state already knows their work or exemption status via state or national databases, Spilinek said.

To check whether enrollees meet the requirement, Nebraska and other states plan to tap into various databases, including Medicaid claims information and data controlled by credit rating agencies. Enrollees for whom Nebraska doesn’t have data will be notified and can complete an online form to confirm they meet the new rules.

While a number of states say they plan to hire extra administrative staff, the Nebraska Medicaid agency is not adding any employees to implement its work requirement.

“The fact that they say they do not need additional resources raises questions” as to whether “they will be able to pull this off without future headaches,” Nordquist said.

Proving employment status will require documentation, but Nebraska officials say they will allow enrollees to self-attest that they volunteer, go to school, or qualify for exemptions, such as for poor health or caring for a disabled parent. “Supporting documentation, such as medical records, will not be required,” Spilinek said.

That could make it easier for enrollees to get exempted under the law’s “medical frailty” exception. The long list of health conditions that can be considered for the exemption was posted last week by the state and includes many types of cancers and mental health and heart conditions.

Kelsey Arends, senior staff attorney for Nebraska Appleseed, an advocacy group, said the state’s long list of medical billing codes for conditions that would be exempted is still not long enough. She said different levels of illness severity are not included.

The exemption is crucial for Crystal Schroer, 30, who has been on Medicaid since 2022 and unemployed since 2024. She said it has been difficult to find work near her home in Kearney, Nebraska, that will allow her to take along her psychiatric service dog, Tarot, who helps her with anxiety.

“I am insanely worried,” said Schroer, who lives with a friend. “It’s made my depression way worse.”

Whether self-attestation will broadly be allowed in other states will depend on CMS’ rules for work requirements, expected to be set this summer. Oz told KFF Health News that “we don’t like self-attesting” and that “documentation is critical.”

Several advocacy groups had asked the state to exempt enrollees with specific conditions, including the American Diabetes Association, HIV+Hepatitis Policy Institute, and National Bleeding Disorders Foundation. Losing coverage, the groups said, would mean losing access to medications that keep people healthy and out of the hospital.

Adding a work requirement to Medicaid has been a priority for Trump since his first term. In 2018, his administration became the first to allow states to adopt the policy, but only Arkansas implemented it. In the nine months the policy was in place before a federal judge deemed it unlawful, more than 18,000 people lost coverage — nearly 1 in 4 of those subject to the requirement.

Most lost coverage not because they did not meet the requirements but for failing to correctly submit paperwork in time. 

Georgia has had a work requirement under its partial Medicaid expansion since 2023. Only about 8,000 people signed up for the coverage in its first two years — far fewer than the 25,000 that state officials predicted for the first year alone — and many have been denied benefits because of paperwork issues.

National Mandate

During the congressional debate over the law last year, Republicans pushed a work requirement for Medicaid as a way to get “able-bodied” adults benefiting from government assistance into the workforce. House Speaker Mike Johnson said it would help preserve Medicaid “for people who rightly deserve it,” not young men “sitting on their couches playing video games.”

Republicans have argued mandating employment will nudge people into finding work, leaving Medicaid to help children and people who are pregnant or have disabilities.

They were not swayed by studies showing most adults on Medicaid already work or go to school or have health conditions preventing them from doing so.

A recent study in the Annals of Internal Medicine found about one-third of adults at risk of losing coverage under the new work requirement reported that they have a physical or mental illness or disability.

“This is not a case that we have mostly healthy adults choosing not to work,” said Darshali Vyas, a study co-author and health policy researcher at Beth Israel Deaconess Medical Center in Boston. “It’s a vulnerable group, and I am not sure there are clear protections as we begin to roll out work requirements.”

In Nebraska, about two-thirds of Medicaid expansion enrollees work or attend school, according to KFF. Nebraska’s unemployment rate is 3%, one of the lowest in the nation.

Andrea Skolkin, the CEO of Omaha-based One World Community Health Centers, said it’s an unsettling time for her clinic and their patients. “We are still concerned about the expanded Medicaid folks losing coverage,” she said.

About 4,000 of their 52,000 patients are covered under the Medicaid expansion, Skolkin said. She said many enrollees received letters from the state about the work requirement, but she worries many did not understand them.

Losing 10% of those patients would mean $500,000 less in revenue for the nonprofit centers, she said. To help patients, they plan to add staff to help people fill out the forms to get and maintain coverage.

Nebraska Appleseed’s Arends said she’s skeptical of the state’s promises to use automation to confirm that enrollees meet the work rules. “We remain very concerned about the early implementation,” she said.

People who lose coverage may have a harder time getting health bills covered if they reenroll in the Medicaid program, because the federal law also reduces retroactive eligibility from three months to one month for expansion enrollees.

Because many people sign up for Medicaid when seeking care for an emergency and it can take weeks or months to complete enrollment, hospitals are concerned the change will leave them to cover the costs when people lose coverage, Nordquist said.

Only two other states plan to implement the work requirement early: Montana, which plans to launch in July, and Iowa, which plans to go live in December.

Many states will be closely watching Nebraska’s implementation to see what lessons they can learn ahead of their own launches in January, said Andrea Maresca, a senior principal at Health Management Associates, a consulting firm.

States are better prepared to enact work requirements than they were when Arkansas tried in 2018, she said. After reconfirming millions of enrollees’ eligibility post-covid, they have more experience using public and private databases to automate the process and more practice communicating with enrollees, Maresca said.

Still, “it won’t be perfect,” and states will have to adapt as they go, she said.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Like many parents, Tatiana Lafortune wants her children to get a good education, eat nutritious food, and see a doctor when they’re not feeling well.

Public schools and her church’s pantry help Lafortune accomplish the first two goals. But insurance to cover doctor visits has been the most difficult to secure.

As nursing assistants at a traumatic brain injury rehab center near Tampa, Florida, Lafortune and her husband cannot afford the health insurance benefits offered by their employer. And they earn too much for their daughters to qualify for subsidized coverage through Florida KidCare, the state’s safety net health insurance program for children in low-income families.

Her family also can’t afford the $525 monthly cost to enroll her two daughters in KidCare at full price, so she purchased a family plan for $500 a month on the Affordable Care Act marketplace with no dental coverage and higher out-of-pocket costs.

“KidCare is better for children,” she said. “But at least I have something for them.”

In 2023, Florida lawmakers unanimously approved expanding KidCare to close the gaps for families like Lafortune’s, raising the eligibility threshold so that coverage would extend to more than 40,000 children. But the expanded coverage has not taken effect — even after it was approved by federal regulators following a federal lawsuit — because the administration of Florida Gov. Ron DeSantis, a Republican, has not implemented the changes.

Instead, Florida’s KidCare expansion has been mired in lawsuits and ongoing negotiations between the state and federal regulators. While the delay continues, Florida could be violating the law.

“I don’t know what they’re waiting for,” Lafortune said. “They should see people in Florida have needs.”

Asked to comment on the delay, DeSantis’ office referred KFF Health News to a video of a press conference on March 31, during which the governor directed questions to the state’s Agency for Health Care Administration, which oversees KidCare. The state agency did not respond to KFF Health News’ repeated requests for an interview or information on the delayed expansion.

Entitlement vs. Personal Responsibility

At issue is a federal rule, adopted under the Biden administration, that requires all states to continue to provide 12 months of coverage for children in Medicaid and in the Children’s Health Insurance Program, known as KidCare in Florida. That means insurance coverage would not lapse even if parents miss a monthly premium payment.

But only Florida has challenged the rule in court, suing the federal government for the right to disenroll children from KidCare for unpaid premiums and delaying the planned expansion.

“We’ve had to do a lot of back and forth with CMS on various things,” DeSantis said during the March press conference, referring to the Centers for Medicare & Medicaid Services, which regulates public health insurance programs.

In December, Texas also said it opposed the rule. Cecile Erwin Young, who was then the executive commissioner of Texas Health and Human Services, wrote to Mehmet Oz, the CMS administrator, asking him to rescind CHIP rules that require states to keep children enrolled for 12 months at a time, prohibit waiting periods for coverage, and prevent states from imposing financial benefit limits.

“These policy changes effectively redefine CHIP to be more like an entitlement program — a strategy not supported by law and which conflicts with the core program design adopted by Texas,” Young wrote.

Like Texas, Florida views KidCare as a “personal responsibility program” designed to help families by “supporting independence and a ladder towards economic self sufficiency,” according to legal filings and presentations to Florida lawmakers.

“It’s something that goes back to this mentality of people needing to pull themselves up by their bootstraps,” said Melanie Andrade Williams, policy director for the Florida Health Justice Project. The nonprofit legal aid group, together with the National Health Law Program, sued Florida’s Medicaid and KidCare agencies on March 9, asking a judge to order the state to implement the approved expansion.

The state agencies had not filed a response to that lawsuit as of April 22. The court ordered the state to explain by mid-May why the expansion should not be implemented.

Williams called the state’s tactic “largely political theater.”

Health policy researchers and advocates also noted that Florida’s refusal to implement the KidCare expansion goes against the Trump administration’s strategy to “Make Our Children Healthy Again.” Last year, a commission appointed by President Donald Trump recommended a series of policy changes, including a collaboration between CMS and state CHIP programs, to promote “evidence-based prevention and wellness initiatives for children at the local level.”

Numerous studies have found that CHIP coverage can improve children’s health by increasing access to care, improving long-term health, and reducing poverty.

“This should go without saying, but you can’t make children healthy again by taking away their health coverage,” said Holly Bullard, chief strategy and development officer for Florida Policy Institute, a nonprofit that has advocated for the state to implement the KidCare expansion.

The White House did not respond to a request for comment on Florida’s and Texas’ opposition to the rule requiring continuous enrollment in CHIP.

Those two states have among the highest numbers and rates of uninsured children. In Texas, more than 1 million children, or 13.5%, have no health insurance, while in Florida more than 400,000 children, or 8.5%, are uninsured.

Texas has followed the federal rule on continuous coverage despite its opposition, but Florida has ignored the requirement and continues to disenroll children for unpaid premiums.

Choosing Between School Supplies and Health Insurance

According to the Florida Healthy Kids Corp., the nonprofit contracted by the state to determine eligibility for and administer KidCare, about 250,000 children received subsidized coverage from Dec. 1, 2024, to Nov. 30, 2025. Of those, 43,000 children were disenrolled after their parents failed to pay the premium.

Joan Alker, director of the Center for Children and Families at Georgetown University, said the Trump administration should act on the evidence that Florida is the only state defying the rule.

“Thousands and thousands of children are routinely losing their coverage in violation of federal law,” she said, “and the Trump administration has done nothing about that. At the same time, they’re pulling money from states like Minnesota for alleged fraud violations that haven’t even been proven yet.”

Families tend to miss premium payments in July and August, when it’s time to buy back-to-school supplies, and again in December and January, around the holidays, Alker said.

“That is very, very sad,” Alker said. “You have working parents here who are struggling and they have to choose between their child’s school supplies and their health insurance.”

This year, enrollment in KidCare has fallen below the state’s projections, leading to a $32 million surplus in the program. On April 17, legislators voted to remove that amount from the program and redirect it to the general fund, with some lawmakers expressing disappointment that the expansion had not yet been implemented.

Lawmakers voted to expand KidCare eligibility to families earning up to 300% of the federal poverty level. The change would raise the income threshold for a family of four from about $5,500 a month to about $8,250 a month. Monthly premiums for subsidized coverage would also rise, from the current $15 to $20 a month to a maximum of $195 a month, regardless of the number of children a family enrolls.

The program provides more comprehensive and affordable coverage than ACA marketplace plans. KidCare has no deductible or coinsurance, and maximum copayments of $15. It also includes dental and vision coverage.

With her ACA plan, Lafortune must pay a $35 copayment for doctor visits. Her family deductible is $1,600, and the coinsurance — or the share of covered services she must pay after meeting the deductible — is 20%. The plan’s maximum out-of-pocket cost is $7,250.

“I tried to get something cheaper, but it’s not like I cannot have it,” Lafortune said of the need for health insurance. “I have to do something.”

The state’s initial lawsuit challenging the continuous eligibility rule was dismissed in May 2024, and a second lawsuit was withdrawn this February. The state and CMS told the judge they were “working to determine the most expeditious way to resolve the dispute” and have yet to update the court on their discussions.

But three days after withdrawing the lawsuit, Florida sued CMS for a third time, accusing the federal agency of ignoring the state’s public records request related to CMS’ approval of the KidCare expansion.

As the legal wrangling continues, the cost of health insurance has skyrocketed.

For those with ACA marketplace coverage, the expiration of enhanced subsidies has hit hard. About half of those who re-enrolled in ACA marketplace coverage for 2026 said their healthcare costs are “a lot higher” this year, according to a recent KFF survey.

For Lafortune, Florida’s KidCare expansion can’t come soon enough.

“Children are the ones who are going to replace everyone here,” she said. “When you give them opportunities — for their health, for school, to eat — you make your country healthy and better.”

Are you struggling to afford your health insurance? Have you decided to forgo coverage? Click here to contact KFF Health News and share your story.

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High-deductible plans can look like a deal, until the bills start rolling in. On this episode of the NPR podcast Life Kit, reporter Jackie Fortiér breaks down what to expect and how to prepare.

A lot of people choose their health insurance the way they shop for a flight — sort by the lowest price and click “buy.” But what looks like a bargain upfront can come with costly consequences later.

After some federal financial aid expired, many Americans found that high-deductible health plans were the only option they could afford.

In a new episode of NPR’s Life Kit podcast, KFF Health News reporter Jackie Fortiér and podcast host Marielle Segarra discuss what these plans are, and why they can feel so confusing. Imagine paying $100 out-of-pocket for a routine doctor visit that used to cost you $20. Imagine shouldering thousands of dollars in bills before your insurance pays a cent.

Still, for some people — especially those who rarely need medical care — high-deductible plans work. Listen to the episode to explore how timing your care and taking advantage of free preventive services can help you make the most of your coverage.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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This story can be republished for free (details).

KFF Health News Michigan correspondent Kate Wells discussed urgent care clinics offering abortions on Apple News Today on April 15.

• Click here to hear Wells on Apple News Today.
• Read Wells’ “Urgent Care Clinics Move To Fill Abortion Care Gaps in Rural Areas.”

KFF Health News Montana correspondent Katheryn Houghton discussed doula Medicaid reimbursements on Montana Public Radio on April 9.

• Click here to hear Houghton on Montana Public Radio.
• Read Houghton’s “This Northern Cheyenne Doula Was About To Start Getting Paid — Then Medicaid Cuts Hit.”

KFF Health News contributor Michelle Andrews discussed farm bureau health plans on The Yonder Report on April 8.

• Click here to hear Andrews on The Yonder Report.
• Read Andrews’ “Farm Bureau Health Plans Beat the ACA on Prices With an Age-Old Tactic: Rejecting Sick People.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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This story can be republished for free (details).