InsuranceCoverage&Costs 092821

The Part of the ‘Free Britney’ Saga That Could Happen to Anyone
By Christopher Magoon Britney Spears was forced into psychiatric care — and compelled to pay for it. That can happen to any patient who has an episode of serious mental illness, piling financial woes onto their stress and vulnerability.

Jaw Surgery Takes a $27,119 Bite out of One Man’s Budget
By Phil Galewitz A Seattle patient discovers the hard way that you can still hit a lifetime limit for certain types of care. And health plans can vary a lot from one job to the next, even if the insurer is the same.

An Ad’s Charge That Price Haggling Would ‘Swipe $500 Billion From Medicare’ Is Incorrect
By Victoria Knight The ad, advanced by a right-leaning seniors advocacy organization, mischaracterizes proposals to bargain on drug prices, regarding both the effects on the Medicare program and on beneficiaries.

The Solution to Au Pairs’ Health Coverage Gaps May Be Simple: ACA Plans
By Bryce Covert Private agencies that bring young adults to the U.S. to care for children generally offer basic health insurance, but plans may exclude many types of necessary care. What the agencies might not mention is that au pairs are eligible to enroll in comprehensive coverage on the Affordable Care Act marketplaces and likely qualify for premium subsidies that would make the insurance affordable.

Democrats Roll the Dice on Sweeping Abortion Rights Bill — Again
By Julie Rovner Capitol Hill lawmakers mobilize to support a bill that would write abortion protections into federal law. Unlikely to succeed, the exercise follows a tactic that proved unsuccessful in 1992.

California’s Reboot of Troubled Medi-Cal Puts Pressure on Health Plans
By Bernard J. Wolfson Photos by Heidi de Marco The nine commercial insurers in Medi-Cal must reapply by submitting bids for new contracts. The state hopes the process will improve care for low-income residents and tighten accountability, something critics say has been missing.

‘An Arm and a Leg’: They Turned Grief Into Action
By Dan Weissmann This episode highlights how New York enacted a charity care law, one of the precursors to the federal provision on charity care in the Affordable Care Act.  

These Schools Use Weekly Testing to Keep Kids in Class — And Covid Out
By Christine Herman, WILL / Illinois Public Media Coronavirus outbreaks have shuttered K-12 classrooms across the U.S., affecting tens of thousands of K-12 students. To avoid the same fate, some school districts are tapping federal dollars to set up testing programs and step up their vigilance against the virus.

Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans
By Phil Galewitz The plans are designed for people who don’t get dental coverage through their jobs and can’t afford an individual plan. For about $300 to $400 a year, patients receive certain preventive services at no charge and other procedures at a discount.

Leader of California’s Muscular Obamacare Exchange to Step Down
By Bernard J. Wolfson and Angela Hart Peter Lee helped create Covered California, which has been lauded as a national example among the Affordable Care Act’s insurance marketplaces, and he fiercely opposed Republican efforts to repeal the federal health reform law.

KHN’s ‘What the Health?’: Much Ado About Drug Prices
Democrats have hit a snag in their effort to compile a $3.5 trillion social-spending bill this fall — moderates are resisting support for Medicare drug price negotiation provisions that would pay for many of the measure’s health benefit improvements. Meanwhile, the new abortion restrictions in Texas have moved the divisive issue back to the political front burner. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat and Shefali Luthra of The 19th join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interview’s KHN’s Phil Galewitz about the latest KHN-NPR “Bill of the Month” installment, about two similar jaw surgeries with very different price tags.

Census: Insured Population Holds Steady, With a Slight Shift From Private to Public Coverage
By Victoria Knight and Julie Appleby The Census Bureau on Tuesday released its 2020 findings regarding Americans’ income, poverty and health insurance coverage.

Health Care Unions Defending Newsom From Recall Will Want Single-Payer Payback
By Angela Hart If Gov. Gavin Newsom survives Tuesday’s recall election, the health care unions that have campaigned on his behalf intend to pressure him to follow through on his promise to establish a government-run health system in California.

Georgia Eyes New Medicaid Contract. But How Is the State Managing Managed Care?
By Rebecca Grapevine and Andy Miller More than 40 states have turned to managed-care companies to control costs in their Medicaid programs, which cover low-income residents and people with disabilities. As Georgia prepares to open bidding on a new contract, the question looms: Has this model paid off?

California Set to Spend Billions on Curing Homelessness and Caring for ‘Whole Body’ Politic
By Angela Hart California is embarking on a five-year experiment to infuse its health insurance program for low-income people with billions of dollars in nonmedical services spanning housing, food delivery and addiction care. Gov. Gavin Newsom said the goal is to improve care for the program’s sickest and costliest members and save money, but will it work?

Watch: Same Providers, Similar Surgeries, But Different Bills
KHN Editor-in-Chief Elisabeth Rosenthal joins "CBS This Morning" to discuss the latest Bill of the Month installment, in which a man discovered the hard way that health plans can vary from one job to the next, even if the insurer is the same.

Biosimilar Drugs Are Cheaper Than Biologics. Are They Similar Enough to Switch?
By Michelle Andrews Biologic drugs, made from living organisms, and the cheaper biosimilar drugs that mimic them are more complex than chemical drugs and their generic counterparts. The Food and Drug Administration says biosimilars are as safe and effective as the biologics, and doctors agree — but they are cautious about changing the treatment regimen of patients doing well.

Why At-Home Rapid Covid Tests Cost So Much, Even After Biden’s Push for Lower Prices
By Hannah Norman Germans pay less than $1 per test. Brits get them free. Why do Americans pay so much more? Because companies can still demand it.

KHN’s ‘What the Health?’: The Autumn of Democrats’ Discontent
Congress is back in session with a short time to finish a long to-do list, including keeping the government operating and paying its bills. Hanging in the balance is President Joe Biden’s entire domestic agenda, including major changes proposed for Medicare, Medicaid and the Affordable Care Act. Meanwhile, the new Texas abortion law that bans the procedure early in pregnancy is prompting action in Washington. Joanne Kenen of Politico, Mary Ellen McIntire of CQ Roll Call and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews former FDA Commissioner Scott Gottlieb about his new book on the covid-19 pandemic.

Florida Spine Surgeon and Device Company Owner Charged in Kickback Scheme
By Fred Schulte Dr. Kingsley R. Chin and SpineFrontier were the subject of a recent KHN “Spinal Tap” investigation.

‘An Arm and a Leg’: How Charity Care Made It Into the ACA
By Dan Weissmann In this episode, we hear how the political tango over guaranteeing that nonprofit hospitals provide charity care nearly tanked the Affordable Care Act — and how the battle over the ACA “broke America.”

KHN’s ‘What the Health?’: The Future of Public Health
The covid pandemic has spotlighted the often-unseen role of public health in Americans’ daily lives. And the picture has not all been pretty. What is public health and why is it so important — and controversial? Dr. Ashish Jha, dean of the Brown University School of Public Health, explains the basics. Then, Joanne Kenen of Politico and Lauren Weber of KHN join KHN’s Julie Rovner to discuss what could happen next.

Medicaid Vaccination Rates Founder as States Struggle to Immunize Their Poorest Residents
By Phil Galewitz Efforts by states and the private health plans that many states pay to cover low-income Americans has been scattershot and hampered by a lack of data.

Dentistas eliminan los problemas de las personas sin seguro ofreciéndoles ellos mismos planes
By Phil Galewitz Estos planes limitados a una práctica están dirigidos principalmente a los 65 millones de estadounidenses que no tienen cobertura dental, y tienen que pagar de su bolsillo toda su atención.

Beneficiarios de Medicaid se vacunan mucho menos contra covid
By Phil Galewitz Si bien más de 202 millones de estadounidenses están vacunados al menos en parte contra covid, casi el 30% de las personas mayores de 12 años siguen sin vacunarse. Las encuestas muestran que los más pobres tienen menos probabilidades de recibir una vacuna.