Joanne Kenen

Joanne Kenen is senior health-policy writer at the New America Foundation and the editor of the New Health Dialogue blog. She spent more than a decade covering health policy on Capitol Hill for Reuters and was a Kaiser Family Foundation Media Fellow in 2006-2007. Her work has appeared in numerous publications including The Washington Post, Washingtonian, and The Atlantic.

Recent Articles

A Second Wind for Health-Care Reform

The deficit commission makes the case for delivering care better and cheaper.

Commission on Fiscal Responsibility and Reform co-chairmen Erskine Bowles, left, and Alan Simpson (AP Photo/Harry Hamburg)
The Affordable Care Act of 2010 (ACA) achieved one big thing -- covering some 32 million more Americans -- but made limited progress toward the other major change that is needed: reforming the way we deliver and pay for health care. Without success on the latter item, implementation of the former is unlikely to be completely successful or politically sustainable. Key to this effort is making Medicare, the country's expensive public health care program for senior citizens, more efficient. The act includes provisions that would reduce wasteful and unnecessary spending under Medicare, partly by experimenting with new ways of caring for the elderly. But those provisions are in danger because Republicans saw the cuts as a political opportunity, inverting the traditional political alignments around Medicare in order to court worried senior voters. Republicans opposed Medicare when it was created and sought to cut its funding dramatically the last time they took over the House of...

A Public Plan for Connecticut?

Despite political and financial hurdles, Connecticut is moving forward with its own state-level public option.

Connecticut could become the first state to offer its own public-plan option, even before most of national health reform unfolds. After several years of debate about expanding coverage, a couple of gubernatorial vetoes, and assorted false starts, Connecticut in 2009 created "SustiNet" -- a framework for what could become a state insurance plan as early as 2012, two years before the state's insurance exchange is up and running as part of national reform. Once the exchange is in place, individuals and small businesses will be able to choose between SustiNet and one of the commercial health plans. Though approved in concept by the state Legislature, SustiNet at this point is only a concept. It has a board, a cadre of volunteer analysts, and task forces as well as support from foundations, advocates, and Democratic legislators. But the commission must go back to the Legislature next year for final approval -- and funding -- in an environment that is fiscally challenging and politically...

National Reform Meets Politics in the States

States are beginning to carry out the law in different ways -- or not at all.

Virginia Attorney General Ken Cuccinelli speaks after Gov. Bob McDonnell signs legislation exempting the state's citizens from the new health-care law. (AP Photo/Bob Brown)
The battle for the passage of health reform may have been won, but the battle over putting it into practice is just beginning. That conflict will unfold not only in Congress, on K Street, and in the courts but also in the states, which are charged with identifying and enrolling the millions of Americans without insurance coverage. The performance of state governments -- how effectively they build on the scaffolding of federal reform, how wisely they spend the available federal dollars, how much backbone they show in resisting pressures from opponents of reform, and how much agility they display in correcting the inevitable technical errors -- ultimately will determine whether the Affordable Care Act fulfills its promise. Establishing insurance exchanges to cover a projected 24 million people, expanding Medicaid to absorb another 16 million, and regulating how insurers treat everyone else is a staggering task. "Implementation is the short suit of American government," says Richard...

Is It Time for Malpractice Reform?

It's not just about tort reform anymore. Using progressive solutions to fix the malpractice system could result in better health care for all.

Year after year, Republicans try to pass legislation that would limit medical malpractice awards. Fix the tort system, they argue, and we fix rising health-care costs. And year after year, Democrats resist placing arbitrary caps on awards to people who may have suffered from an egregious medical error. The fight plays out like a predictable old Western -- good guys versus bad guys. Depending on your politics, the villain is either the greedy doctor or the greedy trial lawyer. Health reform invites a fresh look at malpractice. The Republican tort-reform agenda hasn't magically fixed what ails American health care in states that have tried it. But progressives can test new models of medical malpractice reform because -- done right -- they may lead to a more consistent, more timely, and more equitable approach to compensating people who have been harmed. As Ezekiel Emanuel, a bioethicist and White House adviser on health policy, writes in his book Healthcare, Guaranteed : There's little...

The Cost of Doing Nothing on Health Care

Forget what reform will cost -- we have to understand the price of a broken system.

President-elect Barack Obama and his new health-reform chief, Tom Daschle, made clear on Thursday that even amid tremendous economic crisis, their new New Deal would take on that persistent piece of unfinished business from the old New Deal -- health care. "Some may ask how at this moment of economic challenge we can afford to invest in reforming our health-care system," Obama said. "And I ask a different question. I ask how can we afford not to." A recent report by the New America Foundation's health-policy program estimates that the cost of doing nothing about health care, including poor health and shorter lifespan of the uninsured, is well above $200 billion a year and rising. That's enough to cover the uninsured and still have some left over for other public-health needs. Health-insurance inflation will continue to outpace wages; the average cost of an employer-sponsored insurance plan for a family would reach $24,000 in 2016, an 84 percent increase from today. At least half of U...