Insurance Coverage and Costs: Aug. 18, 2022

The Ambulance Chased One Patient Into Collections
By Bram Sable-Smith After a car wreck, three siblings were transported to the same hospital by ambulances from three separate districts. The sibling with the most minor injuries got the biggest bill.

Upended: How Medical Debt Changed Their Lives
By Noam N. Levey and Aneri Pattani and Yuki Noguchi, NPR News and Bram Sable-Smith People talk about the sacrifices they made when health care forced them into debt.

The Debt Crisis That Sick Americans Can’t Avoid
By Elisabeth Rosenthal The federal government is stepping in to assist student loan borrowers. But little public attention has been focused on what is — statistically, at least — a bigger, broader debt crisis in our country: An estimated 100 million people in the U.S., or 41% of all adults, are saddled with pernicious health care debt.

Sleepless Nights Over Her Children’s Future as Debts Pile Up
By Noam N. Levey Jeni Rae Peters, 44, Rapid City, South Dakota Approximate Medical Debt: More than $30,000 Medical Issue: Breast cancer What Happened: Jeni Rae Peters’ budget has always been tight. But Peters, a single mom and mental health counselor, has worked to provide opportunities for her children, including two girls she adopted and a succession of foster […]

For Medically Vulnerable Families, Inflation’s Squeeze Is Inescapable
By Heidi de Marco Inflation hasn’t hit Americans like this in decades. And families living with chronic diseases have little choice but to pay more for the medicine, supplies, and food they need to stay healthy.

After Wiping Out $6.7 Billion in Medical Debt, This Nonprofit Is Just Getting Started
By Yuki Noguchi, NPR News Nonprofit RIP Medical Debt buys up unpaid hospital bills plaguing low-income patients and frees them from having to pay.

Inflation Reduction Act Contains Important Cost-Saving Changes for Many Patients — Maybe for You 
By Michael McAuliff The legislation, which the House is expected to pass Friday, would allow the federal government, for the first time, to negotiate the price of some drugs that Medicare buys. It also would extend the enhanced subsidies for people who buy insurance on the Affordable Care Act marketplaces.

No, the Senate-Passed Reconciliation Bill Won’t Strip $300 Billion From Medicare
By Louis Jacobson, PolitiFact Under the Medicare drug negotiations provisions in the reconciliation bill, the federal government would see its outlays reduced by about $300 billion. That reduction wouldn’t result from cuts in benefits. Instead, Medicare would be empowered to leverage its market power to pay lower prices for certain drugs.

Big Pharma Went All In to Kill Drug Pricing Negotiations
By Arthur Allen For more than a century, the drug industry has issued dire warnings of plunging innovation whenever regulation reared its head. In general, the threat hasn’t materialized.

Watch: Explaining the Nitty-Gritty of Medicare Drug Price Negotiations — And Patients’ Potential Savings
KHN chief Washington correspondent Julie Rovner discusses the Senate Democrats’ plans to let Medicare negotiate some drug prices, cap out-of-pocket drug costs for seniors, and fund enhanced subsides for ACA marketplace health plans.

Ad Targeting Manchin and AARP Mischaracterizes Medicare Drug-Price Negotiations
By Victoria Knight and Colleen DeGuzman The advocacy group American Commitment said empowering Medicare to negotiate drug prices would raid it of billions of dollars. Drug pricing experts say that that’s not the case and that such policies would instead reduce costs for the Medicare program and seniors.

Rapper Fat Joe Says No One Is Making Sure Hospitals Post Their Prices
By Julie Appleby A TV and social media ad offers a reason to check on the enforcement of a sweeping rule that requires hospitals to post information about what they charge insurers and cash-paying patients.

Even Well-Intended Laws Can’t Protect Us From Inaccurate Provider Directories
By Bernard J. Wolfson State and federal laws require health plans to offer accurate lists of participating doctors and facilities, but consumers still struggle to get timely appointments with providers.

KHN’s ‘What the Health?’: A Big Week for Biden
Congress is leaving for its annual summer break having accomplished far more than many expected, including, barring unforeseen snags, a bill to address the cost of prescription drugs for Medicare beneficiaries and extend the enhanced subsidies for insurance premiums under the Affordable Care Act. Meanwhile, the abortion issue continues to roil the nation as Indiana becomes the first state to ban the procedure in almost all cases since the Supreme Court overruled the constitutional right to abortion in June. Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet, and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these issues and more.

Buy and Bust: Collapse of Private Equity-Backed Rural Hospitals Mired Employees in Medical Bills
By Sarah Jane Tribble The U.S. Labor Department investigates Noble Health after former employees of its shuttered Missouri hospitals say the private equity-backed owner took money from their paychecks and then failed to fund their insurance coverage.

Nursing Homes Are Suing the Friends and Family of Residents to Collect Debts
By Noam N. Levey Debt lawsuits — long a byproduct of America’s medical debt crisis — can ensnare not only patients but also those who help sick and older people be admitted to nursing homes, a KHN-NPR investigation finds.

Health Insurance Price Data: It’s Out There, but It’s Not for the Faint of Heart
By Julie Appleby Health insurers and self-insured employer plans are now required to post their negotiated rates for almost every type of medical service. But navigating through the trove of information is no easy task.

Community Health Centers’ Big Profits Raise Questions About Federal Oversight
By Phil Galewitz and Bram Sable-Smith Nonprofit federally funded health centers are a linchpin in the nation’s health care safety net because they treat the medically underserved. The average profit margin is 5%, but some have recorded margins of 20% or more in three of the past four years.

They Lost Medicaid When Paperwork Was Sent to an Empty Field, Signaling the Mess to Come
By Brett Kelman Tennessee expects to soon disenroll about 300,000 people from its Medicaid program. But families like the Lesters have suffered when bureaucracy and clerical mistakes caused them to unfairly lose coverage under the same program.

‘True Cost of Aging’ Index Shows Many Seniors Can’t Afford Basic Necessities
By Judith Graham The Elder Index, developed by researchers at the University of Massachusetts-Boston, shows that nearly 5 million older women living alone, 2 million older men living alone, and more than 2 million older couples have incomes that make them economically insecure.

Watch: How Nursing Homes Put Friends and Families on the Hook for Residents’ Debts
In pursuit of unpaid bills, nursing homes across Rochester, New York, have been suing relatives and friends of their residents. This CBS News report, done in partnership with a KHN-NPR investigation, takes a look at the practice and tells the stories of some of the people affected.

‘So Rudderless’: A Couple’s Quest for Autism Treatment for Their Son Hits Repeated Obstacles
By Michelle Andrews Amparo and Victor Rios began searching for answers about their son’s development when he didn’t hit some milestones after turning 2. Three years later, they are still trying to get their insurance to pay for expensive therapy to help him.

Parents Become Drug Developers to Save Their Children’s Lives
By Jared Whitlock Families affected by ultra-rare diseases are starting their own companies to speed the development of treatments for their kids, venturing into territory that traditional drugmakers deem too risky.

California Gov. Newsom Pins Political Rise on Abortion, Guns, and Health Care
By Angela Hart As California Gov. Gavin Newsom claims the role as the national Democratic Party’s political attack dog, he is trolling red-state governors over their positions on guns and abortion. He’s also making a case for himself — with health care front and center.

Listen: Can California Lower the Price of Insulin?
California Healthline senior correspondent Angela Hart describes California’s ambitious plan to manufacture generic insulin under the state’s new “CalRx” drug label.

‘An Arm and a Leg’: Her Bill for a Prenatal Test Felt Like a ‘Bait-and-Switch’ Scheme
By Dan Weissmann Her doctor told her the noninvasive genetic test would be $99. When she called, she was told $250 and if she didn't pay quickly it could be $800.

Journalists Put Polio, Price Transparency, and a Personal Covid Battle in Perspective
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.

Journalists Scrutinize Retail Giants’ Push Into Health Care and Government’s HIV Surveillance
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.