Julie Rovner

Casa de Salud, a nonprofit clinic in Albuquerque, N.M., provides primary medical care, opioid addiction services and non-Western therapies, including acupuncture and reiki, to a largely low-income population.

And as with so many other health care institutions that serve as a safety net, this clinic's revenue — and its future — are threatened by the COVID-19 pandemic.

In one of his first proposals since becoming the presumptive Democratic presidential nominee, Joe Biden is wading back into the roiling waters of health policy.

In a nod to the effects of COVID-19 on the economy, and in what is clearly an overture to supporters of the "Medicare for All" plan pushed by Vermont Sen. Bernie Sanders, Biden wants to lower the age of eligibility for Medicare from 65 to 60.

Health care has been a leading issue in the presidential campaign over the past year, as Democratic candidates have clashed with each other, and especially with President Trump. But voters, who tell pollsters that health is among their top concerns, also complain that the health debate has been confusing and hard to follow.

With voting about to begin in many states, here's a guide to some key health care terms, issues and policy differences at play.

Universal coverage, "Medicare for All" and single-payer are not the same thing

Jan. 22 marks the 47th anniversary of Roe v. Wade, the landmark court case that legalized abortion nationwide. People on both sides of the furious debate say this could be the year when everything changes.

In March, the U.S. Supreme Court will hear its first abortion case since Justice Brett Kavanaugh replaced Anthony Kennedy, who had been the swing vote on abortion cases. A decision is expected by summer.

You're forgiven if in the holiday blur you missed that a federal appeals court in New Orleans has once again put the future of the Affordable Care Act in doubt. Or if you missed the news last week that a group of Democratic state attorneys general has asked the Supreme Court to hear the case in this term — which ends in June. That would mean a decision could come right in the middle of the 2020 presidential and congressional campaigns.

Any day now, the 5th U.S. Circuit Court of Appeals in New Orleans could rule that the entire Affordable Care Act is unconstitutional.

At least it seemed that two of the three appeals court judges were leaning that way during oral arguments in the case, State of Texas v. USA, in July.

The one thing we know about health care in the 2020 Democratic presidential primary race is that it's a top issue for voters.

The latest Tracking Poll from the Kaiser Family Foundation in late November found 24% of Democrats and Democratic-leaning independents said they want to hear the candidates discuss health care. That's twice the total for the next top issue, climate change, and four times the total for immigration, the No. 3 issue.

It was a moment of genuine bipartisanship at the House Ways and Means Committee in October, as Democratic and Republican sponsors alike praised a bill called the "Restoring Access to Medication Act of 2019."

The bill, approved by the panel on a voice vote, would allow consumers to use their tax-free flexible spending accounts or health savings accounts to pay for over-the-counter medications and women's menstrual products.

The newest faculty member at the Uniformed Services University of the Health Sciences has a great smile ― and likes to be scratched behind the ears.

Shetland, not quite 2 years old, is half-golden retriever, half-Labrador retriever. As of this fall, he is also a lieutenant commander in the Navy and a clinical instructor in the Department of Medical and Clinical Psychology at USUHS in Bethesda, Md.

The politics of health care are changing. And one of the most controversial parts of the Affordable Care Act — the so-called "Cadillac tax" — may be about to change with it.

The Cadillac tax is a 40% tax on the most generous employer-provided health insurance plans — those that cost more than $11,200 per year for an individual policy or $30,150 for family coverage. It was a tax on employers and was supposed to take effect in 2018, but Congress has delayed implementation twice.

The headlines about presidential candidate Joe Biden's new health care plan called it "a nod to the past" and "Affordable Care Act 2.0." That mostly refers to the fact that the former vice president has specifically repudiated many of his Democratic rivals' calls for a "Medicare for All" system, and instead sought to build his plan on the ACA's framework.

The fate of the Affordable Care Act is again on the line Tuesday, as a federal appeals court in New Orleans takes up a case in which a lower court judge has already ruled the massive health law unconstitutional.

State attorneys general and women's health advocates who are hoping to block in court new Trump administration rules for Title X, the federal family planning program, face one major obstacle: The Supreme Court upheld very similar rules in 1991.

Those rules were summarily canceled after a change in administrations. But the court is arguably more conservative than it was 28 years ago.

With Democrats now in control of the U.S. House of Representatives, it might appear that the fight over abortion rights has become a standoff.

After all, abortion-rights supporters within the Democratic caucus will be in a position to block the kind of curbs that Republicans advanced over the past two years when they had control of Congress.

But those on both sides of the debate insist that won't be the case.

If last Friday's district court ruling that the Affordable Care Act is unconstitutional were to be upheld, far more than the law's most high-profile provisions would be at stake.

In fact, canceling the law in full — as Judge Reed O'Connor in Fort Worth, Texas, ordered in his 55-page decision — could thrust the entire health care system into chaos.

Once again, Medicare is moving front and center in this fall's campaigns.

Throughout the election season, Democrats have been criticizing Republicans over votes and lawsuits that would eliminate insurance protections for pre-existing conditions for consumers.

But now Republicans are working to change the health care conversation with a tried-and-true technique used by both parties over the years: telling seniors their Medicare coverage may be in danger.

New York University's School of Medicine is learning that no good deed goes unpunished.

The highly ranked medical school announced with much fanfare this month that it is raising $600 million from private donors to eliminate tuition for all its students — even providing refunds to those currently enrolled. Before the announcement, annual tuition at the school was $55,018.

Senate Democrats, who are divided on abortion policy, are instead turning to health care as a rallying cry for opposition to Brett Kavanaugh, President Trump's Supreme Court nominee.

Specifically, they are sounding the alarm that confirming the conservative U.S. Court of Appeals judge could jeopardize one of the Affordable Care Act's most popular provisions — its protections for people with pre-existing health conditions.

What would the U.S. look like without Roe v. Wade, the 1973 case that legalized abortion nationwide?

That's the question now that President Trump has chosen conservative Judge Brett Kavanaugh as his nominee to replace retiring Supreme Court Justice Anthony Kennedy.

The Trump administration is refusing to defend key parts of the Affordable Care Act, essentially arguing that federal courts should find the health law's protections for people with pre-existing conditions unconstitutional.

The federal lawsuit hinges on the ACA's individual mandate, or the requirement to get health coverage or pay a penalty. The mandate has long been a sticking point for conservatives, who argue that the government should not be telling individuals what coverage they must have.

The Affordable Care Act very nearly failed to become law back in 2010 because of a dispute among Democrats over how to handle abortion in the bill.

Now a similar argument between Democrats and Republicans is slowing progress on a bill that could help cut soaring premiums and help stabilize the ACA.

At issue is the extent to which the Hyde Amendment — language commonly used by Congress to prohibit most federal abortion funding — should be incorporated into any new legislation affecting the health law.

A bipartisan group of senators and House members has been working since last summer toward measures to keep prices from rising out of control and undermining the individual market—the market that serves people who don't get insurance through work or through the government. Members hope to attach a package of fixes to what should be the year's final temporary spending bill, due late this month.

As a presidential candidate, Donald Trump promised abortion opponents four specific actions to "advance the rights of unborn children and their mothers."

One year into his presidency, three of those items remain undone. Nevertheless, opponents of abortion have made significant progress in changing the direction of federal and state policies.

A day after President Trump said the Affordable Care Act "has been repealed," officials reported that 8.8 million Americans have signed up for coverage on the federal insurance exchange for 2018 — nearly reaching the 2017 number in half the sign-up time.

That total is far from complete. Enrollment is still open in parts of seven states, including Florida and Texas, that use the federal HealthCare.gov exchange but were affected by hurricanes earlier this year.

Republicans officially pulled the plug on their last-ditch effort to repeal and replace the Affordable Care Act on Tuesday.

"We don't have the votes," said Sen. Bill Cassidy, R-La., after a closed-door meeting of Senate Republicans. "And since we don't have the votes, we've made the decision to postpone the vote." Cassidy, along with Sen. Lindsey Graham, R-S.C., put together the proposal they hoped could pass the Senate.

In his high-stakes strategy to overhaul the federal health law, President Donald Trump is threatening to upend the individual health insurance market. But if the market actually breaks, could anyone put it back together again?

Back in January, Republicans boasted they would deliver a "repeal and replace" bill for the Affordable Care Act to President Donald Trump's desk by the end of the month.

In the interim, that bravado has faded as their efforts stalled and they found out how complicated undoing a major law can be. With summer just around the corner, and most of official Washington swept up in scandals surrounding Trump, the health overhaul delays are starting to back up the rest of the 2018 agenda.

After weeks of will-they-or-won't-they tensions, the House managed to pass its GOP replacement for the Affordable Care Act on Thursday by a razor-thin margin. The vote was 217-213.

Democrats who lost the battle are still convinced they may win the political war. As the Republicans reached a majority for the bill, Democrats on the House floor began chanting, "Na, na, na, na ... hey, hey, hey ... goodbye." They say Republicans could lose their seats for supporting a bill that could cause so much disruption in voters' health care.

Updated 5 pm April 3, 2017 to include the proposed Upton amendment.

The House may yet pass its bill to repeal and replace parts of the Affordable Care Act. But Republicans' options to fulfill their seven-year effort to undo the federal health law are getting narrower by the day.

"As of now, they still don't have the votes," said Rep. Pete King (R-N.Y.) as he was leaving a meeting of GOP members Tuesday. King has been heavily lobbied by both sides.