Insurance, Coverage, and Costs: Jan. 15, 2025
He Went in for a Colonoscopy. The Hospital Charged $19,000 for Two.
Harris Meyer
A man in Chicago with a troubling symptom underwent a common procedure. Then he wanted to know why the hospital charged nearly three times its own cost estimate.
Obamacare Sign-Ups Lag After Trump Election, Legal Challenges
Julie Appleby
The number of new and returning enrollees using healthcare.gov — the federal marketplace that serves 31 states — is well below last year’s as of early December. Also, a Biden administration push to give “Dreamers” access to Obamacare coverage and subsidies is facing court challenges.
Trump’s Return Puts Medicaid on the Chopping Block
Phil Galewitz
Republicans in Washington are working on plans to shrink Medicaid, the nearly $900-billion-a-year government health insurance program that covers 1 in 5 Americans.
New Year, New Congress, New Health Agenda
Health is unlikely to be a top priority for the new GOP-led 119th Congress and President-elect Donald Trump. But it’s likely to play a key supporting role, with an abortion bill already scheduled for debate in the Senate. Meanwhile, it’s unclear when and how the new Congress will deal with the bipartisan bills jettisoned from the previous Congress’ year-end omnibus measure — including a major deal to rein in the power of pharmacy benefit managers. In this “catch up on all the news you missed” episode, Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Lauren Weber of The Washington Post join KFF Health News’ Julie Rovner to discuss these stories and more.
Medicaid Expansion Debate Will Affect Other Health Policy Issues Before Montana Legislature
Mike Dennison and Sue O'Connell
Legislative leaders say the decision whether to renew Montana’s Medicaid expansion program this year will loom over behavioral health spending and hospital regulation, among other topics.
Health Care Is Newsom’s Biggest Unfinished Project. Trump Complicates That Task.
Angela Hart and Christine Mai-Duc
As Gov. Gavin Newsom enters the second half of his final term, health care stands out as his most ambitious but glaringly incomplete initiative for California residents. The issue will likely shape his national profile for better or worse. And now, Donald Trump brings a new wrinkle.
Health Insurers Limit Coverage of Prosthetic Limbs, Questioning Their Medical Necessity
Michelle Andrews
Advocates say it is discrimination and are arguing for “insurance fairness” on the grounds that people who have joints surgically replaced typically don’t face the same kinds of coverage challenges.
Journalists Wrap Up 2024 With Topics From Trump 2.0 to Frustration With Health Industry
KFF Health News 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.
Doctors, Nurses Press Ahead as Wildfires Strain Los Angeles’ Health Care
Bernard J. Wolfson and Molly Castle Work and Emily Alpert Reyes, Los Angeles Times
A primary care clinic burned, medical offices closed, and hospitals struggled with possible evacuations. The wildfires that have incinerated large swaths of Los Angeles County are stressing the region’s health care infrastructure. Still, providers continue to find ways to deliver vital care.
Indiana State Senator Moves To Scrap Hospital Monopoly Law He Helped Create
Samantha Liss
After rival hospitals in Terre Haute scuttled plans to merge, a state senator has introduced a bill to forbid similar mergers by repealing a state law he helped write.
Biden Administration Bars Medical Debt From Credit Scores
Noam N. Levey
The move, which comes less than two weeks before President-elect Donald Trump is set to take office, represents a challenge to the new administration.
In Year 7, ‘Bill of the Month’ Gives Patients a Voice
In the seventh year of KFF Health News’ “Bill of the Month” series, patients shared their most perplexing, vexing, and downright expensive medical bills, and reporters analyzed $800,000 in charges — including more than $370,000 owed by 12 patients and their families.
‘Bill of the Month’: The Series That Dissects and Slashes Medical Bills
Elisabeth Rosenthal
Since 2018, readers and listeners sent KFF Health News-NPR’s “Bill of the Month” thousands of questionable bills. Our crowdsourced investigation paved the way for landmark legislation and highlighted cost-saving strategies for all patients.
For Many Rural Women, Finding Maternity Care Outweighs Concerns About Abortion Access
Lillian Mongeau Hughes
A legislative effort to expand access to prenatal care in rural Oregon with mobile clinics was scuttled because those clinics would have provided abortions in rural areas. Opposition to the proposal shows that, even in states that ensure access to abortions, that care isn’t universally available or accepted.
In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M
Fred Schulte
A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.
Employers Press Congress To Cement Health Price Transparency Before Trump’s Return
Julie Appleby
Donald Trump’s first administration advanced rules forcing hospitals and insurers to reveal prices for medical services. Employers don’t want to risk backtracking during Trump’s second administration.
Rage Has Long Shadowed American Health Care. It’s Rarely Produced Big Change.
Noam N. Levey
The outpouring of anger at health insurers following the killing of UnitedHealthcare CEO Brian Thompson continues a cycle of rage that dates back decades.
Cinco cambios críticos que puede sufrir Medicaid bajo Trump
Phil Galewitz
Los republicanos en Washington afirman que planean utilizar recortes de financiamiento y cambios regulatorios para reducir drásticamente Medicaid, el programa de salud federal gerenciado por los estados
La salud, un proyecto inconcluso del gobernador de California
Angela Hart and Christine Mai-Duc
Algunas de las iniciativas emblemáticas de Newsom en materia de salud, que podrían definir su perfil en el escenario nacional, están en peligro con el regreso de Donald Trump a la Casa Blanca.
Elección de Trump y desafíos legales retrasan las inscripciones en el Obamacare
Julie Appleby
Las nuevas inscripciones bajo la Ley de Cuidado de Salud a Bajo Precio (ACA) parecen ser hasta un millón menos que el número récord del año pasado, especialmente por problemas con el programa que enfrenta la saliente administración Biden.