Julie Appleby

Unauthorized Sign-Ups Cast Shadow on Obamacare’s Record Enrollment

KFF Health News Original

The Biden administration faces what looks like a growing problem for the federal Affordable Care Act’s insurance exchange: disreputable insurance brokers enrolling people who don’t need coverage or switching them to new plans without their authorization. It happened to Michael Debriae, a restaurant server who lives in Charlotte. Unbeknownst to him, an agent in Florida […]

A Battle Between Drugmakers and Insurers Hits Patients in the Wallet

KFF Health News Original

There’s a long-running battle between insurers and drugmakers over financial assistance programs that purport to help patients afford expensive drugs. And lately, insurers have been losing ground as lawmakers, regulators and courts weigh in. The issue is whether coupons and other copay aid many patients get from drugmakers should count toward annual insurance deductibles and […]

When Copay Assistance Backfires on Patients

KFF Health News Original

Drugmakers offer copay assistance programs to patients, but insurers are tapping into those funds, not counting the amounts toward patient deductibles. That leads to unexpected charges. But the practice is under growing scrutiny.

Biden’s Got a New Set of Orders for Obamacare. Is It His Last?

KFF Health News Original

The Biden administration has issued its latest official wish list for Obamacare insurance plans, potentially one of the last major Affordable Care Act health policy efforts in the president’s first term. Changes on tap for 2025? For one, the administration wants states that run their own ACA marketplaces to crack down on what’s called “network […]

Hospitals and Doctors Are Fed up With Medicare Advantage

KFF Health News Original

Medicare Advantage plans are pretty popular with both lawmakers and ordinary Americans — they now enroll about 31 million people, representing just over half of everyone in Medicare, by KFF’s count. But among doctors and hospitals, it’s a different story. Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans […]