Very early this morning the U.S. House passed a bill that would result in more than 7 million people losing Medicaid coverage if it became law; that estimate is from the Congressional Budget Office.

As the bill was coming together, the chief Washington correspondent for KFF Health News shared her analysis. Julie Rovner highlighted that to get a bill across the finish line was going to require overcoming the skepticism of some politicians. “There’s a growing group of Republicans who are unhappy with how many reductions there are to the Medicaid program… including people who voted for the Republican [Party] and President Trump,” she said.

Rovner also reviewed the Trump administration’s efforts to ignore congressional appropriations and other laws. “As I say, this administration… is not following the law” and Rovner explained how that threatens the country’s public health.

From the future of Medicaid and food assistance to questions about accountability and health infrastructure, this conversation offers crucial insights into the latest health policy flashpoints with hosts Mark Masselli and Margaret Flinter.

Millions are still living with the effects of Long COVID and new research shows that for older adults, the consequences may be profound and lasting.

In part one of a special two-part series on “Conversations on Health Care,” Dr. Gabriel de Erausquin, a neurologist and leading Long COVID researcher at the University of Texas Health San Antonio, shares groundbreaking findings from his global study of over 3,500 patients. His work reveals a troubling connection: many Long COVID patients over 60 show cognitive decline that mirrors early signs of dementia.

“The parts of the brain that are affected by COVID overlap significantly with those that are affected early in the course of Alzheimer’s….the changes overlap, but they are not identical.”

His team is now studying brain imaging and biomarkers to understand the link between COVID-related cognitive decline and traditional neurodegenerative diseases like Alzheimer’s disease.

Dr. de Erausquin also explains how persistent loss of smell — a hallmark COVID symptom — may be the strongest predictor of ongoing cognitive issues, and how genetic sequencing is helping uncover inherited risk.

He highlights a dual reality: while many Long COVID patients show biological changes, others had prior diagnoses of depression, anxiety, or chronic fatigue — a nuance often missing from public conversations.

Click to hear the full conversation with hosts Mark Masselli and Margaret Flinter.

Early voting is underway in most of the U.S. right now (with few exceptions) and health care is on the ballot. There are increasing signs that former President Trump, if re-elected, will try to proceed with “massive changes” to the Affordable Care Act. Meanwhile, Vice President Kamala Harris is vowing to protect the law and continue federal drug price negotiations. Both candidates say they’ll seek to expand support for in-home health care.

Our guests are the reporters covering these issues. Shannon Firth, MedPage Today’s correspondent in Washington, shares an update from a contentious U.S. House race in Minnesota that’s focused on abortion. Sarah Owermohle, who reports on federal issues for STAT News, explains the situation in Montana following her recent visit to the state.

Join Mark Masselli and Margaret Flinter for our Reporters’ Roundtable as we countdown to election day and discuss what the results will mean for the nation’s health.        

Yale University researcher Akiko Iwasaki, Ph.D., says immune profiling shows how Long COVID patients have distinct features not found in control groups. These patients, who also exhibit elevated levels of exhausted T-cells, cause her to express surprise at skeptics.

Iwasaki joins Fiona Lowenstein, editor of “The Long COVID Survival Guide,” to discuss patients who say they’re suffering from Long COVID for as much as two years after their acute phase of the disease.

Iwasaki also explains why her lab’s effort to move forward with a COVID nasal spray faces financial hurdles.

Listen in to this important conversation with hosts Mark Masselli and Margaret Flinter.

FDA vaccine advisor Dr. Paul Offit’s recent article in JAMA Pediatrics looks at the millions of 5- to 11-year-old children who received the COVID vaccine.

His in-depth research review found that the mRNA vaccine was effective at preventing COVID, symptomatic infection, hospitalization, and multisystem inflammatory syndrome in children. The vaccine was also safe; myocarditis occurred in very rare cases.

Dr. Offit joins hosts Mark Masselli and Margaret Flinter to discuss his findings and why he supports the end of the public health emergency.

A top World Health Organization public health official is adding nuance to the agency’s call for more transparency from China, which is coping with a crippling COVID-19 outbreak since it ended its zero-COVID policy last month.

Maria Van Kerkhove, Ph.D., WHO Technical Lead for COVID-19 Response, tells “Conversations on Health Care” that “We really need better understanding on the burden and the hospitalizations and we need more information on the sequences…they have detected known sub-variances…but we need those sequences to be shared publicly. We want China to work with us to really determine within those sublineages…is there anything else within those sequences that’s different. And we need a global community to look at that. And work directly with us to do a full risk assessment.

“Right now they’re going through a massive wave of Omicron. This virus, as transmissible as it is, is passing through the population. They are sharing information. It’s just not enough. It’s just not as detailed as we’d like.”

Van Kerkhove joins hosts Mark Masselli and Margaret Flinter to share her insights.

Dr. Richard Besser, who once led the Centers for Disease Control and Prevention, doesn’t believe the recently enacted U.S. COVID testing requirement for anyone arriving from China will have much of an impact.

Besser, who is currently president and CEO of the Robert Wood Johnson Foundation, says he feels such actions are often “more for show than truly for controlling a public health threat” and recalls that 14 years ago possible border closings during the H1N1 outbreak were seen as ineffective.

Besser joins hosts Mark Masselli and Margaret Flinter to share his insights about the XBB.1.5 Omicron Subvariant, ways to strengthen public health and the tripledemic threat (RSV, COVID and the flu).

We’re proud to have again served as a platform for trusted, informed experts during the third year of the pandemic.

This week “Conversations on Health Care” looks back on some of the most insightful comments from doctors and scientists who are on the frontlines of fighting COVID. In addition to NIH’s Dr. Anthony Fauci we had as our guests Dr. Peter Hotez from Baylor College of Medicine, Dr. Zeke Emanuel at the University of Pennsylvania, Dr. Michael Osterholm from the University of Minnesota, Dr. Mary Bassett with the New York City Health Department and others.

Listen in as hosts Mark Masselli and Margaret Flinter capture their insights about these extraordinary medical challenges.

In early November Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to President Biden, joined us with important pandemic details. It marked his 7th interview with us during his amazing tenure.

His COVID comments on our program were picked up by ABC, NBC and many other news outlets and they’re still relevant right now as we face what he called “the emergence of sublineage variants of Omicron.”

Listen in as Dr. Fauci shares his wisdom with hosts Mark Masselli and Margaret Flinter as he prepares to leave NIH after over 50 years of public service.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to President Biden, tells “Conversations on Health Care” that he’s thinking about what occurs after he leaves his position at the end of the year.

Fauci says he’s strictly adhering to ethical rules and not negotiating for any position until after he leaves the government but he broadly wants to utilize his 54 years of experience at the National Institutes of Health for writing, lecturing and serving in an advisory capacity to inspire the younger generation to pursue their interests in medicine, science and public health.

Hosts Mark Masselli and Margaret Flinter note that this is Fauci’s fifth interview with them since the pandemic began and they again use the opportunity to ask him about the latest COVID details.

Dr. Jennifer Nuzzo leads the Pandemic Center at the Brown University School of Public Health; she was initially hired for the role by Dr. Ashish Jha, who is now the White House Coronavirus Response Coordinator.

Dr. Nuzzo tells hosts Mark Masselli and Margaret Flinter that COVID remains a fairly significant health threat, especially in terms of possible variants, but we’re not in the same situation we were two years ago. She reacts to President Biden’s recent statements about the state of the pandemic and believes one way to assess its end is how people are living today.

CDC Director Dr. Rochelle Walensky and colleagues will soon review data for the new bivalent booster shot for COVID; she says it relates to very small changes in the mRNA sequence and that “shouldn’t impact safety at all…if we wait for those data to emerge in human data…not just mice data but human data…we would be using what I would consider to be a potentially outdated vaccine…it’s best to use a vaccine that’s tailored to the variant we have right now.”

Still, Dr. Walensky urges anyone who’s eligible to get the current booster right now while the U.S. government reviews the bivalent research. She points out that most of the cases of severe disease and death from COVID are unvaccinated or under-vaccinated people. “We have now given over 600 million doses of this vaccine in this country so we have an extraordinary safety profile, probably unlike any we’ve seen with any vaccine in history.”

Listen in to this important conversation with hosts Mark Masselli and Margaret Flinter.

Former Centers for Disease Control and Prevention director Dr. Tom Frieden shares his thoughts about the news Dr. Anthony Fauci will soon leave government service. Frieden explains how the next director of the National Institute of Allergy and Infectious Diseases will need to be realistic that he or she will have big shoes to fill.

Frieden, who now leads the nonprofit Resolve to Save Lives, also tells hosts Mark Masselli and Margaret Flinter that he endorses an independent commission to review what happened during the COVID pandemic. He was interviewed as part of a CDC review and he lays out what must change in terms of its mission, approach and budget.

Renowned epidemiologist and innovator Dr. Larry Brilliant says we’ve entered an “age of pandemics” as the Biden administration declares the monkeypox outbreak a public health emergency.

Dr. Brilliant is the chair of the advisory board of Ending Pandemics, a nonprofit working to find outbreaks faster around the world. His expertise is a result of his success in helping the World Health Organization eradicate smallpox in the 1970s.

He also discusses with hosts Mark Masselli and Margaret Flinter the limits of the mRNA vaccines for COVID and why a nasal spray is needed.

U.S. health officials now estimate 7–23 million Americans have developed Long COVID, which can last weeks or months.

Admiral Rachel L. Levine, MD, Assistant Secretary for Health, U.S. Department of Health and Human Services, joins “Conversations on Health Care” to push back against Long COVID doubters.

She says, “We don’t know exactly what is causing Long COVID, it might not be one thing, but Long COVID is real and those patients need support and they need treatment. We want to emphasize that patients are not malingering but we don’t know exactly what causes it. It might be a chronic infection with COVID-19 or a chronic inflammatory response.”

Admiral Levine is hopeful research will provide more answers for Long COVID and other conditions that are similar.

She also discusses the latest on monkeypox, access to reproductive health and LGBTQ+ issues with hosts Mark Masselli and Margaret Flinter.

Dr. Eric Topol, one of the most prominent and prolific COVID experts, provides his thoughts on the COVID BA.5 subvariant. He says, “it’s the worst variant… [because of] the immune escape…the ability to have growth, fitness and advantages that we haven’t seen before…the properties are getting worse…and lasting longer. The virus has not finished its evolutionary arc. There’s more to come, unfortunately.”

Conversations on Health Care hosts Mark Masselli and Margaret Flinter also talk to Dr. Topol about Dr. Anthony Fauci’s legacy, Paxlovid resistance and monkeypox.

The U.S. Dept. of Veterans Affairs operates the nation’s largest integrated health care system. But how much do you know about how well VA Medical Centers and clinics identify innovative therapies, practices and policies and then diffuse them across a large footprint?

Ryan Vega, MD, MSHA, leads the Innovation Ecosystem within the Veterans Health Administration. This initiative focuses on being the catalyst for enabling the discovery and spread of mission-driven health care innovation to advance care delivery and service.

Dr. Vega highlights point-of-care manufacturing and its 3D Printing Network that were essential during the early days of COVID and the VA’s history of deploying the first cardiac pacemaker.

Conversations on Health Care hosts Mark Masselli and Margaret Flinter talk to Dr. Vega about these breakthroughs, how they help the entire health care sector and where the VA is partnering with Federally Qualified Health Centers.

Joseph Allen is the director of the Healthy Buildings Program at Harvard University’s T.H. Chan School of Public Health. As the co-author of “Healthy Buildings: How Indoor Spaces Drive Performance and Productivity,” his views are closely followed as we try to move quicker than COVID can spread.

“Conversations on Health Care” co-hosts Mark Masselli and Margaret Flinter talk with Allen about new efforts to elevate the quality of indoor spaces in an overall health strategy.

Dr. Peter Hotez, who helped develop a patent-free COVID-19 vaccine, has tested positive himself for a breakthrough strain of the virus. He explained to “Conversations on Health Care” that he’s doing “pretty well” and is confident that’s because he’s fully vaccinated and double-boosted.

Dr. Hotez shared with hosts Mark Masselli and Margaret Flinter that he’d been taking the oral antiviral medication Paxlovid when the interview was recorded. He said it’s a good drug with solid evidence but also suggested that the amount of virus and its replication may ultimately require a longer course of treatment with Paxlovid; right now it’s only approved for five days.

Dr. Hotez also addresses questions about rising cases, booster shots, the anti-science movement and other important issues.

The Atlantic staff writer Ed Yong says the threat of future pandemics requires society to aggressively face and fix racial, economic and health disparities.

The acclaimed journalist also explains how his reporting is showing big differences in how COVID is still affecting the U.S. — some communities are “cautiously optimistic” while others are “nearing…the height of the Omicron surge in terms of new admissions.”

Conversations on Health Care hosts Mark Masselli and Margaret Flinter also talk with Yong about the need for the public health profession to have a strong politically- and socially-minded voice, as it did in its earlier days.