Insurance, Coverage, and Costs: Jan. 19, 2023
The Case of the Two Grace Elliotts: A Medical Billing Mystery
Mark Kreidler
A health system charged a woman for a shoulder replacement at a hospital across the country that she had not visited for years. She didn’t receive the care, but she did receive the bill — and the medical records of a stranger.
KHN-NPR’s ‘Bill of the Month’ at 5: A Treasury of Solutions for Confounding Medical Bills
Readers and listeners shared more than 1,000 personal stories of medical billing problems with KHN-NPR’s “Bill of the Month” investigative series this year, helping us illuminate the financial decisions patients are pressed to make in their most vulnerable moments.
Her Credit Was Ruined by Medical Debt. She’s Been Turned Away From Doctors, Jobs, and Loans
Aneri Pattani
When Penelope Wingard's cancer went into remission, she lost her Medicaid coverage in North Carolina. Without insurance, the debts piled up for her follow-up care. She doesn't think she'll ever get ahead of it.
From Her View in Knoxville, the Health System Is ‘Not Designed for Poor People’
Noam N. Levey
Monica Reed was the first in her family to own a home and has lived "a frugal kind of life." Cancer treatment left her with almost $10,000 in debt, pushing her to the edge financially.
Watch: Patient Sent to Collections for Surgery She Never Had
KHN Editor-in-Chief Elisabeth Rosenthal joins "CBS This Morning" to discuss how difficult a clerical error can be to fix and how patients can respond if it happens to them.
Numbers Don’t Lie. Biden Kept His Promise on Improving Obamacare.
Julie Appleby
KHN has teamed up with our partners at PolitiFact to monitor 100 key promises made by Joe Biden during the 2020 presidential campaign — including those surrounding the Affordable Care Act.
ER Doctors Call Private Equity Staffing Practices Illegal and Seek to Ban Them
Bernard J. Wolfson
Doctors, consumer advocates, and some lawmakers are looking forward to a California lawsuit against private equity-backed Envision Healthcare. The case is part of a multistate effort to enforce rules banning corporate ownership of physician practices.
A Medical Cost-Sharing Plan Left Pastor With Most Of The Cost
Bram Sable-Smith
Jeff and Kareen King joined a medical cost-sharing plan advertised as a "refreshing non-insurance approach" to paying for health care. It had a big proviso: Preexisting conditions like Jeff's heart condition were not fully covered for the first two years. He needed heart surgery after just 16 months.
The Biggest, Buzziest Conference for Health Care Investors Convenes Amid Fears the Bubble Will Burst
Darius Tahir
This year’s JPMorgan confab, the first since covid’s chilling effect on such gatherings, was full of energy and enthusiasm. But it was also marked by questions about the future of health care investment.
Telehealth Brings Expert Sexual Assault Exams to Rural Patients
Arielle Zionts
Some rural residents must travel hours for a sexual assault exam. Specialized telehealth services are expanding so they can obtain care closer to home.
Want a Clue on Health Care Costs in Advance? New Tools Take a Crack at It
Julie Appleby
Another effort to make upfront cost comparisons possible in an industry known for its opaqueness: an online tool for consumers to get some idea of what they may pay for medical care.
California Attorney General Sues Drugmakers Over Inflated Insulin Prices
Angela Hart and Samantha Young
California Attorney General Rob Bonta is taking three major drugmakers and three distributors to court, alleging the companies illegally raised prices at the expense of diabetes patients.
California Senate’s New Health Chair to Prioritize Mental Health and Homelessness
Rachel Bluth
California state Sen. Susan Talamantes Eggman of Stockton has been appointed chair of the Senate’s influential health committee. A licensed social worker, Eggman said she will make mental health care and homelessness front-burner issues.
Behavioral Telehealth Loses Momentum Without a Regulatory Boost
Darius Tahir
As flexible treatment options spurred by the covid pandemic wane, patients relying on medications classified as controlled substances worry that without action to extend the loosened rules, it’ll be harder to get their meds.
Will Your Smartphone Be the Next Doctor’s Office?
Hannah Norman
Entrepreneurs see smartphones as an opportunity to meet patients where they are. But many app-based diagnostic tools still need clinical validation to get buy-in from health care providers.
Many Families With Unaffordable Employer Coverage Now Eligible for Covered California Subsidies
Bernard J. Wolfson
If family coverage on an employer-sponsored plan is too expensive, a worker’s spouse and dependents may be eligible for Affordable Care Act subsidies under a new federal rule.
After a Brief Pandemic Reprieve, Rural Workers Return to Life Without Paid Leave
Jazmin Orozco Rodriguez
Coastal and politically progressive states have passed stronger paid sick and family leave policies, but many workers in rural America are left out, facing tough decisions when choosing between caring for themselves or sick family members or keeping their jobs.
The Decision of Where to Seek Care Is Complicated by the Multitude of Options
Sam Whitehead
The proliferation of care options — particularly urgent care centers and free-standing emergency departments — can make the head spin. Facilities have little incentive to clear up the confusion of where to go. But for patients, the wrong choice can mean big bills and possibly poor health outcomes.
More Orthopedic Physicians Sell Out to Private Equity Firms, Raising Alarms About Costs and Quality
Harris Meyer
While some doctors seem eager for a huge payoff, others are warily watching what happens when private equity firms take charge of orthopedic practices.
Why Medicaid Expansion Ballots May Hit a Dead End After a Fleeting Victory in South Dakota
Rachana Pradhan and Daniel Chang
Since 2017, Medicaid expansion has been adopted in seven states where a question was placed directly on the ballot. But campaign leaders say that strategy may not work in Florida and Wyoming, where Republican opposition remains strong.
After Tuition, Books, and Room and Board, Colleges’ Rising Health Fees Hit a Nerve
Phil Galewitz
Many colleges require students to have health insurance coverage, and the college option can be costly. In addition, some schools mandate that students pay a fee to cover health services on campus.
Centene, Under Siege in America, Moved Into Britain’s National Health Service
Christine Spolar
A nine-minute public hearing gave the U.S. insurance giant a foothold in Britain’s prized National Health Service. One doctor called it “privatization of NHS by stealth.” And critics worry that business efficiencies will degrade the quality of care.
‘An Arm and a Leg’: Getting Insurance to Pay for Oral Surgery Is Like Pulling Teeth
Dan Weissmann
A car crash left a woman in need of oral surgery, but her health insurance wouldn’t cover it. Her ongoing fight shows podcast host Dan Weissmann the weird way insurance treats teeth and reveals a big problem in the Obamacare marketplace.
‘An Arm and a Leg’: The Year in Review, From Prenatal Testing to Insulin Pricing
Dan Weissmann
The editorial team of “An Arm and a Leg” looks back on the reporting that hit close to home over the past year, including insulin pricing and prenatal testing.
Readers and Tweeters Chime In on Disability Rights and Drug Discounts
KHN gives readers a chance to comment on a recent batch of stories.
Muchas familias con cobertura de empleador inasequible ahora son elegibles para subsidios de Covered California
Bernard J. Wolfson
El gobierno federal ha corregido recientemente una controversial norma del Departamento del Tesoro vinculada a la Ley de Cuidado de Salud a Bajo Precio (ACA), que denegaba la ayuda a muchas familias cuya cobertura basada en sus trabajos se salía de sus presupuestos.
¿Clínica de urgencias o sala de emergencias? Cómo decidir donde recibir la atención adecuada
Sam Whitehead
Las personas heridas o enfermas deben decidir con cuidado, en un momento de estrés, cuál es el mejor lugar para buscar ayuda. Y deben tomar esa decisión en medio de un número creciente de opciones.