Alison Kodjak

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RACHEL MARTIN, HOST:

In her first speech as speaker of the House, Nancy Pelosi made it clear that she knows that health care is key to why voters sent Democrats to Congress.

"In the past two years the American people have spoken," Pelosi told members of Congress and their families who were gathered Thursday in the House chamber for the opening day of the session.

The skyrocketing cost of many prescription drugs in the U.S. can be blamed primarily on price increases, not expensive new therapies or improvements in existing medications as drug companies frequently claim, a new study shows.

Copyright 2018 NPR. To see more, visit https://www.npr.org.

Editor's note: This story was updated with enrollment figures made available on Dec. 19.

About 8.5 million people enrolled in health plans for 2019 through the federal HealthCare.gov website by the Dec. 15 deadline.

That's about 367,000 fewer people than signed up during the 6 week open enrollment season last year, a decline of about 4 percent, according to new numbers from the Department of Health and Human Services.

Jenna Neikirk was nearing the end of her first pregnancy when her blood pressure shot up to dangerous levels.

"I started feeling splotchy and hot, just kind of uncomfortable, so I took my blood pressure at work and it was 160 over 120," she says. Neikirk's a physical therapist in Atlanta and knew that level was alarmingly high.

She left work and walked over to her obstetrician's office, which was in the same medical complex.

The couch is dark brown corduroy with lumpy cushions. There are a few telltale smears of food, maybe yogurt or a banana, and some crumbs here and there. It's a well-loved piece of furniture.

Margaret Siebers plops herself down in the center and reaches out to baby daughter Frances, who climbs onto her mother's lap to breastfeed.

"This is where I spent several months," says Siebers, with a shrug. Her 4-year-old, Violet, runs around nearby. "I could come downstairs and sit on the couch."

Voters in three traditionally Republican states supported ballot measures to extend Medicaid benefits to more low-income adults.

The results highlight the divide between voters, even in conservative states, who generally support providing health benefits to the poor, and conservative politicians who have rejected the expansion, which is a central part of the Affordable Care Act.

It's time for consumers who buy their own health insurance to start shopping for policies for next year. Open enrollment for Affordable Care Act coverage starts Thursday across most of the country.

But the shopping and buying experience will vary widely, depending on where people live.

In California, for example, where political leaders have always been supportive of the Affordable Care Act, legislators have allocated $100 million for outreach.

It wasn't all that long ago that Grant Burningham was homeless and sleeping in a tent in the woods.

"That's hard for me to talk about because I thought I had reached the end," he says.

Burningham, a former financial adviser from Bountiful, Utah, developed serious medical problems 17 years ago. Back in 2001, Burningham offered to donate his stem cells to his sister for a transplant. It required multiple procedures, and each time Burningham was given high doses of a medication to boost his immune system.

"And then I got really sick," he says.

Rural Americans are preoccupied with the problems of opioid and drug addiction in their communities, citing it as a worry on par with concerns about local jobs and the economy, according to a new poll from NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.

If you're looking for cheaper health insurance, a whole host of new options will hit the market starting Tuesday.

But buyer beware!

If you get sick, the new plans – known as short-term, limited duration insurance — may not pay for the medical care you need.

Sometimes IV bags are hard for hospitals to come by. Other times it's injectable folic acid to treat anemias. Right now, the tissue-numbing agent lidocaine is in short supply.

Shortages of commonplace generic drugs have plagued hospitals in recent years. And with short supplies and fewer suppliers for key drugs, there have been price increases.

Consumers who buy insurance through the Affordable Care Act markets may be pleasantly surprised this fall as average premiums are forecast to rise much less than in recent years.

The price of a 2019 policy sold on the ACA exchanges will increase less than 4 percent, according to an analysis of preliminary filings from insurers in all 50 states by ACASignups.net, a website and blog run by analyst Charles Gaba that tracks ACA enrollment and insurer participation.

And those insurers are expanding their offerings.

A Texas man has a heart attack – and good medical insurance – and still finds himself on the hook for $109,000 in medical bills.

Another man in Florida owed $3,400 for a CT scan, after his insurance company pays its part.

People who don't get insurance through their jobs will now be able to buy short-term policies that may be cheaper than Affordable Care Act coverage. These plans won't have to cover as many medical services and are exempt from covering people with pre-existing conditions.

The departments of Health and Human Services, Labor and Treasury announced new rules Wednesday that make it easier for consumers to replace ACA insurance with these short-term policies.

Copyright 2018 NPR. To see more, visit http://www.npr.org/.

NOEL KING, HOST:

Eight months pregnant, the drug sales representative wore a wire for the FBI around her bulging belly as she recorded conversations with colleagues at a conference in Chicago. Her code name? Pampers.

Over the last six years, enough opioids were shipped to the state of Missouri to give every resident 260 pills.

The finding comes from a report released Thursday by Sen. Claire McCaskill, D-Mo. It's the latest in a series of investigations by the senator into the role of drugmakers, distributors and other industry players in fueling the opioid epidemic.

A federal judge has blocked work requirements for Medicaid patients in Kentucky, just days before new rules mandated by Gov. Matt Bevin's administration were set to go into effect.

In Friday's ruling, U.S. District Judge James Boasberg called the Trump administration's approval of the program, Kentucky HEALTH, "arbitrary and capricious."

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