Insurance Archives - Page 36 of 187

A Judicial Body Blow to the ACA

Episode 291

March 30, 2023

A federal judge in Texas has dealt a big setback to the Affordable Care Act. The same judge who tried in 2018 to declare the entire ACA unconstitutional has now ruled that the law’s main provisions for preventive care are unconstitutional and, therefore, unenforceable nationwide. Also this week, North Carolina became the 40th state to expand Medicaid under the ACA. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Sandhya Raman of CQ Roll Call join KHN chief Washington correspondent Julie Rovner to discuss these issues and more.

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A photo of a mother and her young child outside of their home.

Bill Of The Month

ER’s Error Lands a 4-Year-Old in Collections (For Care He Didn’t Receive)

A Florida woman tried to dispute an emergency room bill, but the hospital and collection agency refused to talk to her — because it was her child’s name on the bill, not hers.

By Daniel Chang

March 29, 2023

A photo of Biden speaking at a podium inside the White House.

Perspective

Obamacare at 13: Biden and a KHN Reporter Remember

The White House gathered the people who helped pass the Affordable Care Act 13 years ago — partly to congratulate themselves but also to emphasize that they still have much work to do to make health care affordable.

By Phil Galewitz

March 24, 2023

Health Providers Scramble to Keep Remaining Staff Amid Medicaid Rate Debate

The ranks of community-based behavioral health providers in Montana have diminished amid rising costs, greater need, and stagnant Medicaid reimbursement rates. Now, as state lawmakers debate solutions, providers are hoping just to cover their costs.

By Keely Larson

March 24, 2023

KHN On Air

Journalists Discuss Medicaid Unwinding and Clawbacks

KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.

March 18, 2023

Two Counties Square Off With California Over Mental Health Duties

The state wants to stop paying Kaiser Permanente for treating severely mentally ill Medi-Cal patients in Sacramento and Solano counties and force the counties to take on the task. The counties’ leaders say they can’t afford it.

By Angela Hart

March 15, 2023

A photo illustration of a doctor filling out a form on a clipboard placed on a blue textured backdrop.

Deadly Denials

Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients

The federal government wants to change the way health insurers use prior authorization — the requirement that patients get permission before undergoing treatment. Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization has become a confusing maze that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New rules may not be enough to solve the problems.

By Lauren Sausser

March 13, 2023

A photo illustration shows a woman handing over a health insurance card over an abstract background of a pulse reading.

Medicaid Health Plans Try to Protect Members — And Profits — During Unwinding

States are turning to the big health insurance companies to keep Medicaid enrollees insured once pandemic protections end in April. The insurers’ motive: profits.

By Phil Galewitz

March 9, 2023

A photo of protesters holding signs that read, "Stop pharma's price abuse" and "Diabetes community dying."

Why Does Insulin Cost So Much? Big Pharma Isn’t the Only Player Driving Prices

Big Pharma may be moving on from squeezing diabetes patients on insulin prices, but it’s the arbitrators that jack up prices for those who can least afford them.

By Arthur Allen

March 9, 2023

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March Medicaid Madness

Episode 287

March 2, 2023

President Joe Biden and Republicans in Congress spent last month sparring over whether to shield Medicare and Social Security from budget cuts — leading some to wonder if Medicaid was on the table instead. Biden and Democrats say no, but some Republicans seem eager to trim federal spending on the health program for Americans with low incomes. And ready or not, artificial intelligence is coming to medical care. Benefits, as well as unintended consequences, are likely. Alice Miranda Ollstein of Politico, Rachel Cohrs of STAT News, and Lauren Weber of The Washington Post join KHN’s chief Washington correspondent, Julie Rovner, to discuss these issues and more.

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After People on Medicaid Die, Some States Aggressively Seek Repayment From Their Estates

States take drastically different approaches to recovering Medicaid money from deceased participants’ estates. Demands for repayment of Medicaid spending can drain the assets a person leaves behind, depending on where they lived.

By Tony Leys

March 2, 2023

Carolina Morga Tapia stands outside in a park with her five children. Two of the youngest are sitting in a green wagon.

California’s Massive Medicaid Program Works for Some, but Fails Many Others

Medi-Cal serves more than one-third of the state’s population — offering a dizzying range of care to a diverse population. In the new “Faces of Medi-Cal” series, California Healthline will assess the program’s strengths and weaknesses through the lives and experiences of its enrollees.

By Angela Hart and Bernard J. Wolfson

March 2, 2023

An illustration shows the shape of Idaho next to a red rubber ink stamp that reads, "disenrolled."

Idaho Dropped Thousands From Medicaid in the Pandemic’s First Years

The removals, detailed in emails between state and federal health officials, hinged on disagreements over how states could disenroll people during the public health emergency. Consumer advocates fear the alleged violation signals the mess to come on April 1, when the pandemic-era Medicaid coverage mandate ends.

By Rachana Pradhan

March 1, 2023

A photo shows President Joe Biden speaking at a podium while blurred hands hold up cellphones in the foreground.

Biden Promises to Fight GOP on ‘Gutting’ Medicaid. Budget Talks Seem Like Another Story.

As many lower-income Americans prepare to lose pandemic-era access to Medicaid, President Joe Biden vowed to stop Republicans from making deeper cuts to lower the national debt. Other changes may still be up for discussion.

By Michael McAuliff

March 1, 2023

A photo shows a woman holding her infant child while facing a window.

Bill Of The Month

Surprise-Billing Law Loophole: When ‘Out of Network’ Doesn’t Quite Mean Out of Network

Billing experts and lawmakers are playing catch-up as providers find ways to get around new surprise-billing laws, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.

By Harris Meyer

Feb. 28, 2023

Letters to the Editor

Readers and Tweeters Urgently Plea for a Proper ‘Role’ Call in the ER

KHN gives readers a chance to comment on a recent batch of stories.

Feb. 27, 2023

A photo shows a woman posing for a portrait outside by a fence.

California Explores Private Insurance for Immigrants Lacking Legal Status. But Is It Affordable?

Nearly half a million Californians without legal residency make too much to qualify for Medicaid yet they can’t afford to buy coverage. A state lawmaker is proposing to open up the state’s health insurance exchange as a first step to providing them affordable insurance.

By Rachel Bluth

Feb. 27, 2023

KHN & PolitiFact HealthCheck

Proposed Medicare Advantage Changes Cannot Accurately Be Called ‘Cuts,’ Experts Say

CMS advanced two proposed changes that could affect Medicare Advantage plans. One would allow the government to recover past overpayments. As a result, it could reduce those insurers’ profits, leading them to increase enrollees' out-of-pocket costs or reduce benefits. But it's inaccurate to characterize the changes as "cuts."

By Madison Czopek, PolitiFact and Yacob Reyes, PolitiFact

Feb. 22, 2023

A photo shows an older woman sitting in a chair and looking to the left.

A Bitter Battle Over the ‘Orphan Drug’ Program Leaves Patients’ Pocketbooks at Risk

Patients who depend upon special drugs to treat rare diseases are caught in the crossfire as drugmakers and the FDA battle over regulations that reward companies for developing treatments for relatively small pools of patients.

By Sarah Jane Tribble

Feb. 22, 2023

Watch: In Insurers’ Eyes, Not All Midwives Are Equal

The first installment of InvestigateTV and KHN’s “Costly Care” series explores one California mother’s experience struggling to get reimbursed for midwifery care and the differences between providers that may determine whether insurance covers them.

Feb. 15, 2023

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