Insurance, Coverage, and Costs: April 25, 2024
FTC Chief Says Tech Advancements Risk Health Care Price Fixing
Julie Rovner and David Hilzenrath
Technological advances including the widespread use of algorithms make it easier for companies to fix prices without explicitly coordinating, Lina Khan said at a KFF event.
Swap Funds or Add Services? Use of Opioid Settlement Cash Sparks Strong Disagreements
Aneri Pattani
The national opioid settlements don’t prohibit using money for initiatives already supported by other means, but doing so could dilute the impact.
After Uphill Battle, Company Is Poised for Takeover of Bankrupt California Hospital
Melissa Montalvo, The Fresno Bee and Bernard J. Wolfson
American Advanced Management, a steadily growing operator of small hospitals, is expected to get the green light from a bankruptcy court next week to take over the shuttered Madera Community Hospital. Some community groups worry about the company’s track record.
California Health Workers May Face Rude Awakening With $25 Minimum Wage Law
Don Thompson
A medical industry challenge to a $25 minimum wage ordinance in one Southern California city suggests health workers statewide could face layoffs and reductions in hours and benefits under a state law set to begin phasing in in June. Some experts are skeptical, however, that it will have such effects.
California Legislators Debate Froot Loops and Free Condoms
Don Thompson
California state lawmakers this year are continuing their progressive tilt on health policy, debating bills banning an ingredient in Froot Loops and offering free condoms for high schoolers.
Unsheltered People Are Losing Medicaid in Redetermination Mix-Ups
Aaron Bolton, MTPR
Some of the nearly 130,000 Montanans who have lost Medicaid coverage as the state reevaluates eligibility are homeless. That’s in part because Montana kicked more than 80,000 people off the program for technical reasons rather than income ineligibility. For unhoused people who were disenrolled, getting back on Medicaid can be extraordinarily difficult.
Medical Providers Still Grappling With UnitedHealth Cyberattack: ‘More Devastating Than Covid’
Samantha Liss
Medical providers say they're still coping with the Change Healthcare cyberattack disclosed in February even though parent company UnitedHealth Group reported that much is back to normal and its revenue is up over last year.
Too Big To Fail? Now It’s ‘Too Big To Hack’
Congress this week had the chance to formally air grievances over the cascading consequences of the Change Healthcare cyberattack, and lawmakers from both major parties agreed on one culprit: consolidation in health care. Plus, about a year after states began stripping people from their Medicaid rolls, a new survey shows nearly a quarter of adults who were disenrolled are now uninsured. Jessie Hellmann of CQ Roll Call, Sarah Karlin-Smith of the Pink Sheet, and Lauren Weber of The Washington Post join KFF Health News’ Mary Agnes Carey to discuss these stories and more. Also this week, KFF Health News’ Julie Rovner interviews Caroline Pearson of the Peterson Health Technology Institute.
Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers
Julie Appleby
The lawsuit filed in federal court alleges that large call centers were used to enroll people into Affordable Care Act plans or to switch their coverage, all without their permission.
When Rogue Brokers Switch People’s ACA Policies, Tax Surprises Can Follow
Julie Appleby
Some tax filers’ returns are being rejected because they failed to provide information about Affordable Care Act coverage they didn’t even know they had.
Nearly 1 in 4 Adults Dumped From Medicaid Are Now Uninsured, Survey Finds
Phil Galewitz
A first-of-its-kind survey of Medicaid enrollees found that nearly a quarter who were dropped from the program in the last year’s unwinding say they’re uninsured.
Attack of the Medicare Machines
Dan Weissmann
In this episode of “An Arm and a Leg,” host Dan Weissmann tells a horror story. Instead of monsters and aliens, it’s about private health insurance companies and algorithms that call the shots on patient care.
Doctors Take On Dental Duties to Reach Low-Income and Uninsured Patients
Kate Ruder
More doctors are integrating oral health care into their practices, filling a need in America’s dental deserts.
After Public Push, CMS Curbs Health Insurance Agents’ Access to Consumer SSNs
Julie Appleby
Days after publication of a KFF Health News article about Obamacare enrollees being switched to different plans without their knowledge or consent, the Centers for Medicare & Medicaid Services took steps to tighten insurance agents’ access to private consumer information on the federal marketplace.
Rising Complaints of Unauthorized Obamacare Plan-Switching and Sign-Ups Trigger Concern
Julie Appleby
Federal and state regulators are mulling what they can do to thwart this growing problem.
Biden Is Right About $35 Insulin Cap but Exaggerates Prior Costs for Medicare Enrollees
Samantha Putterman, PolitiFact
Most Medicare enrollees likely were not paying a monthly average of $400 — as President Joe Biden stated — before the insulin cap took effect. However, because costs and other factors result in widely varying prices, some Medicare enrollees might have paid that much in a given month.
ACA Plans Are Being Switched Without Enrollees’ OK
Julie Appleby
Insurance agents say it’s too easy to access consumer information on the Affordable Care Act federal marketplace. Policyholders can lose their doctors and access to prescriptions. Some end up owing back taxes.
Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
Susan Jaffe
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
Feds Join Ranks of Employers with Generous Fertility Benefits
Michelle Andrews
Starting this year, federal employees can choose plans that cover a broad menu of fertility services, including up to $25,000 annually for in vitro fertilization procedures. At the same time, politics around IVF and reproductive health have become a central issue in the current election-year debate.
The Supreme Court and the Abortion Pill
The Supreme Court this week heard its first abortion case since overturning Roe v. Wade in 2022, about an appeals court ruling that would dramatically restrict the availability of the abortion pill mifepristone. But while it seems likely that this case could be dismissed on a technicality, abortion opponents have more challenges in the pipeline. Meanwhile, health issues are heating up on the campaign trail, as Republicans continue to take aim at Medicare, Medicaid, and the Affordable Care Act — all things Democrats are delighted to defend. Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet, and Lauren Weber of The Washington Post join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KFF Health News’ Tony Leys, who wrote a KFF Health News-NPR “Bill of the Month” feature about Medicare and a very expensive air-ambulance ride. Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too.
California Is Expanding Insurance Access for Teenagers Seeking Therapy on Their Own
April Dembosky, KQED
A California law that takes effect this summer will grant minors on public insurance the ability to get mental health treatment without their parents’ consent, a privilege that their peers with private insurance have had for years. But the law has become a flashpoint in the state’s culture wars.
The Burden of Getting Medical Care Can Exhaust Older Patients
Judith Graham
It’s estimated that an older patient can spend three weeks of the year getting care — and that doesn’t count the time it takes to arrange appointments or deal with insurance companies.
A State-Sanctioned Hospital Monopoly Raises Concerns
Brett Kelman and Samantha Liss
Hospitals Cash In on a Private Equity-Backed Trend: Concierge Physician Care
Phil Galewitz
Hospitals are increasingly stretching a velvet rope, offering “concierge service” to an affluent clientele. Critics say the practice exacerbates primary care shortages.
Journalists Assess the Risks of Bird Flu and the Impacts of Medicaid ‘Unwinding’
KFF Health News 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.
Readers Speak Up About Women’s Health Issues, From Reproductive Care to Drinking
KFF Health News gives readers a chance to comment on a recent batch of stories.
Casi 1 de cada 4 adultos desafiliados de Medicaid siguen sin seguro, indica encuesta
Phil Galewitz
Las protecciones que tuvo el programa durante la pandemia, que impedían que se expulsaran beneficiarios, expiraron la primavera pasada.
Médicos de atención primaria asumen tareas de dentista para ayudar a pacientes vulnerables
Kate Ruder
En Denver, la inestabilidad de la vivienda, las barreras del idioma, la falta de transporte y el "costo astronómico" de la odontología sin seguro hacen que la atención dental sea inaccesible para muchos nuevos inmigrantes.
Adolescentes podrían ir al psicólogo sin tener el permiso de sus padres
April Dembosky, KQED
Según la nueva ley en California, los jóvenes podrán hablar con un terapeuta sobre la identidad de género sin el consentimiento de sus padres. Pero no podrán recibir tratamiento residencial, medicación o cirugía de afirmación de género sin el visto bueno de sus padres, como han sugerido algunos opositores.
Programas de inteligencia artificial diagnostican retinopatía diabética en minutos
Hannah Norman
En medio de todo el revuelo en torno a la inteligencia artificial en la atención médica, la tecnología de exámenes de la vista está surgiendo como uno de los primeros casos de uso probados de diagnósticos basados en IA en un entorno clínico.
Adultos mayores, agotados por tener que organizar tanta atención médica
Judith Graham
Un nuevo estudio revela que los pacientes de Medicare dedican aproximadamente tres semanas al año a hacerse pruebas médicas, ver a doctores, someterse a tratamientos o procedimientos médicos, o pasar tiempo en el hospital o en centros de rehabilitación.