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Insurance, Coverage, and Costs: 102424

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Thursday, Oct 24 2024

Colorado’s Naloxone Fund Is Drying Up, Even as Opioid Settlement Money Rolls In

Claire Cleveland

Since Colorado created a pool of money to pay for naloxone in 2019, it has distributed more than half a million doses of the opioid reversal drug to hundreds of organizations throughout the state. Now, its main funding stream is drying up.

Patients Are Relying on Lyft, Uber To Travel Far Distances to Medical Care

Michael Scaturro

Uber and Lyft have become a critical part of the nation’s infrastructure for transporting ailing people from their homes — even in rural areas — to medical care sites in major cities such as Atlanta.

Helene and CVS Land Double Whammy for 25,000 Patients Who Survive on IV Nutrition

Arthur Allen

A Massachusetts woman ended up stranded in the hospital because CVS stopped providing the IV nutrition she needs to survive at home. Without it, she’d starve.

PBM Math: Big Chains Are Paid $23.55 To Fill a Blood Pressure Rx. Small Drugstores? $1.51.

Andy Miller

Criticism of prescription drug middlemen has intensified recently in the wake of a federal agency’s actions and legislative reform attempts. Georgia Republican Gov. Brian Kemp, though, vetoed a related bill that would have helped independent pharmacies, citing the unfunded cost of the move.

Voters Fret High Medical Bills Are Being Ignored by Presidential Rivals

Noam N. Levey

Health care hasn’t figured prominently on the campaign trail this fall. These voters wish it would.

Medicare Drug Plans Are Getting Better Next Year. Some Will Also Cost More.

Susan Jaffe

Every year, Medicare officials encourage beneficiaries to shop around for their drug coverage. Few take the time. This year, it might be more important than ever.

California Continues Progressive Policies, With Restraint, in Divisive Election Year

Don Thompson

This legislative cycle, Gov. Gavin Newsom signed bills affirming reproductive rights and mandating insurance coverage of in vitro fertilization, but the Democrat was reluctant to impose new regulations and frequently cited costs for vetoing bills.

LIVE From KFF: Health Care and the 2024 Election

The Affordable Care Act has not been a major issue in the 2024 campaign, but abortion and reproductive rights have been front and center. Those are just two of the dozens of health issues that could be profoundly affected by who is elected president and which party controls Congress in 2025. In this special live episode, Tamara Keith of NPR, Alice Miranda Ollstein of Politico, and Cynthia Cox and Ashley Kirzinger of KFF join KFF Health News chief Washington correspondent Julie Rovner to discuss how health policy has affected the campaign and how the election results might affect health policy. Plus, the panel answers questions from the live audience.

Harris Backs Slashing Medical Debt. Trump’s ‘Concepts’ Worry Advocates.

Noam N. Levey

The Biden administration has taken significant steps to address a problem that burdens 100 million people in America, but gains would be jeopardized by a Trump win, advocates say.

Yet Another Promise for Long-Term Care Coverage

As part of her presidential campaign, Vice President Kamala Harris has rolled out a plan for Medicare to provide in-home long-term care services. The proposal would fill a longtime need for families trying to simultaneously care for young children and older parents, but its enormous price tag makes it a promise unlikely to be fulfilled. Meanwhile, a growing number of Republican candidates up and down the ballot facing voter backlash over their support for abortion restrictions are trying to reinvent their positions. Shefali Luthra of The 19th, Jessie Hellmann of CQ Roll Call, and Joanne Kenen of Johns Hopkins University and Politico join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, excerpts from a KFF lunch with “Shark Tank” panelist and generic drug discounter Mark Cuban, who has been consulting with the Harris campaign about health care issues.

Montana Looks To Fast-Track Medicaid Access for Older Applicants

Katheryn Houghton

As Montana’s population ages, providers serving low-income seniors say more people aren’t getting the care they need as they wait to get on Medicaid. Montana lawmakers are considering creating a shortcut to that care.

Employers Haven’t a Clue How Their Drug Benefits Are Managed

Arthur Allen

The Big Three pharmacy benefit managers say they return nearly all the rebates they get from drugmakers to the employers and insurers who hire them. But most employers seem to doubt that.

What’s New and What To Watch For in the Upcoming ACA Open Enrollment Period

Julie Appleby

This year’s start date in most states is Nov. 1, and consumers may encounter new scams as well as important rule changes.

The Health of the Campaign

The 2024 presidential race is taking on a familiar tone — with Democrats accusing Republicans of wanting to ban abortion and repeal the Affordable Care Act and Republicans insisting they have no such plans. Voters will determine whom they believe. Meanwhile, for the second time in a month, a state judge overturned an abortion ban, but few expect the decision to settle the matter. Alice Miranda Ollstein of Politico, Sandhya Raman of CQ Roll Call, and Anna Edney of Bloomberg News join KFF Health News chief Washington correspondent Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF Health News’ Lauren Sausser, who reported and wrote the latest KFF Health News-Washington Post “Bill of the Month,” about a teenage athlete whose needed surgery lacked a billing code.

Harris Correct That Trump Fell Short on Promise To Negotiate Medicare Drug Prices

Jacob Gardenswartz

The former president instead favored a temporary model that could’ve brought down prices of some prescription drugs, but it was blocked by the courts.

Vance-Walz Debate Highlighted Clear Health Policy Differences

KFF Health News and PolitiFact staffs

The vice presidential debate showcased the very different views of Ohio Republican Sen. JD Vance, Donald Trump’s running mate, and Democratic Gov. Tim Walz, Kamala Harris’ VP pick, on health policies past and present.

Beneficiarios de Medicare gastarán menos en medicamentos en 2025

Susan Jaffe

El período de inscripción anual para que los beneficiarios de Medicare renueven o cambien su cobertura de medicamentos, o elijan un plan Medicare Advantage, comenzó el 15 de octubre y se extiende hasta el 7 de diciembre.

Some Employers Test Arrangement To Give Workers Allowance for Coverage

Michelle Andrews

Employers are showing interest in a type of health reimbursement account that gives workers a contribution to choose and buy their own plans, rather than participating in group plans.

The Medicare Advantage Influence Machine

Fred Schulte and Holly K. Hacker

New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.

In Chronic Pain, This Teenager ‘Could Barely Do Anything.’ Insurer Wouldn’t Cover Surgery.

Lauren Sausser

An Alabama teen was told he needed surgery for debilitating hip pain. But his family’s insurer denied coverage for the procedure, which lacked a medical billing code. Expected to pay more than $7,000, his father charged it to credit cards.

Vance Rewrites History About Trump and Obamacare

Julie Appleby

During the Trump administration, enrollment in Affordable Care Act health plans fell by more than 2 million people and the number of uninsured Americans rose.

Extended-Stay Hotels, a Growing Option for Poor Families, Can Lead to Health Problems for Kids

Andy Miller and Renuka Rayasam

Extended-stay hotels are often a last resort for low-income families trying to avoid homelessness. But hotel living can lead to — or exacerbate — various physical and mental health issues for children, say advocates for families and researchers who study homelessness.

A California Official Helped Save a Mental Health Company’s Contract. It Flew Him to London.

Molly Castle Work

The director of a California state mental health agency traveled to the U.K. courtesy of Kooth, a digital mental health company with a $271 million contract to build a therapy app for the state’s youth. Weeks earlier, he pressed key legislative staffers to restore a proposed cut to Kooth’s funding.

Long-Term Care Facilities Must Provide Addiction Care, Advocates Say

Henry Larweh

Journalists Weigh In on Racial Trauma, Medicaid Expansion, and Opioid Settlements

KFF Health News and California Healthline staffers made the rounds on national and local media recently to discuss topical stories. Here’s a collection of their appearances.

Journalists Address Opioid Settlements, Undiagnosed ADHD, and a Georgia Chemical Fire

KFF Health News and California Healthline staff made the rounds on national and local media in the last two weeks to discuss topical stories. Here’s a collection of their appearances.

Harris apoya la reducción de la deuda médica. Los “conceptos” de Trump preocupan a defensores.

Noam N. Levey

La administración Biden ha ampliado las protecciones financieras para los pacientes, incluyendo una propuesta histórica de la Oficina de Protección Financiera del Consumidor (CFPB) para eliminar la deuda médica de los informes de crédito de los consumidores.

Lo nuevo y lo que debes tener en cuenta en el próximo período de inscripción abierta de ACA

Julie Appleby

Estamos en esa época del año otra vez. En la mayoría de los estados, la temporada de inscripción abierta de la Ley de Cuidado de Salud a Bajo Precio (ACA) para los planes de salud comienza el 1 de noviembre y dura hasta el 15 de enero.

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