Insurance, Coverage, and Costs: Jan. 4, 2024

When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill
By Darius Tahir For the patient, it was a quick and inexpensive virtual appointment. Why it cost 10 times what she expected became a mystery.

Woman Petitions Health Insurer After Company Approves — Then Rejects — Her Infusions
By Lauren Sausser Illustration by Oona Zenda Even people with good insurance aren't guaranteed affordable care, as this KFF Health News follow-up to one patient’s saga shows.

Utah Survey Shows Why So Many People Were Dumped From Medicaid
By Phil Galewitz It’s one of the biggest mysteries in health policy: What happened to millions of Americans kicked out of Medicaid last year? A survey conducted for state officials in Utah, obtained by KFF Health News, holds some clues. Like many states, Utah terminated Medicaid coverage for a large share of enrollees whose eligibility was reevaluated in […]

States Expand Health Coverage for Immigrants as GOP Hits Biden Over Border Crossings
By Phil Galewitz More than 1 million immigrants, most lacking permanent legal status, are covered by state health programs. Several states, including GOP-led Utah, will soon add or expand such coverage.

Cancer Patients Face Frightening Delays in Treatment Approvals
By Lauren Sausser Delaying cancer treatment can be deadly — which makes the roadblock-riddled process that health insurers use to approve or deny care particularly daunting for oncology patients.

Bold Changes Are in Store for Medi-Cal in 2024, but Will Patients Benefit?
By Bernard J. Wolfson California’s Medicaid program is undergoing major changes that could improve health care for residents with low incomes. But they are happening at the same time as several other initiatives that could compete for staff attention and confuse enrollees.

California’s Ambitious Medicaid Experiment Gets Tripped Up in Implementation
By Angela Hart The health care insurers, nonprofit organizations, and other groups responsible for implementing Gov. Gavin Newsom’s ambitious plan to infuse Medicaid with social services say their ability to serve vulnerable, low-income Californians is hamstrung.

An Arm and a Leg: To Get Health Insurance, This Couple Made a Movie
By Dan Weissmann On this episode of “An Arm and a Leg,” hear how a couple wrote and directed a short film, starring one of them — just to maintain health insurance through the actors union.

KFF Health News' 'What the Health?': Trump Puts Obamacare Repeal Back on Agenda
Although Republicans have never united behind a replacement for the Affordable Care Act, 2024 GOP presidential front-runner Donald Trump said this week he wants to put the issue back on the national agenda. That delights Democrats, who have won at least two elections partly by defending the now-popular health law. Meanwhile, the Texas Supreme Court takes up a case brought by women who say their pregnancy complications further endangered their health due to the vagueness of Texas’ near-total ban on abortions. Joanne Kenen of Johns Hopkins University and Politico Magazine, Sarah Karlin-Smith of the Pink Sheet, and Victoria Knight of Axios News join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KFF Health News’ Rachana Pradhan, who reported and wrote the latest “Bill of the Month” feature.

Biden Wants States to Ensure Obamacare Plans Cover Enough Doctors and Hospitals
By Julie Appleby The regulatory proposal was announced Nov. 15 and is likely one of the last major ACA policy efforts of the president’s first term.

Dodging the Medicare Enrollment Deadline Can Be Costly
By Susan Jaffe As open enrollment ends, many people are tuning out. They could wind up with a surprise next year: higher costs and less access to health care providers.

Millions of Dollars Flow From Pharma to Patient Advocacy Groups
By Rachana Pradhan Pharma money is all over the place — in universities, companies doing continuing medical education for doctors and in prominent patient advocacy organizations that are household names across America. Public Citizen, a consumer advocacy nonprofit, reports today that between 2010 and 2022, the drug industry’s main lobbying group and member companies provided at least $6 […]

In New Year, All Immigrants in California May Qualify for Medicaid Regardless of Legal Status
By Bernard J. Wolfson In the new year, California’s Medicaid program will open to otherwise eligible immigrants ages 26 to 49 without legal residency. They will join children, young adults, and adults over 50 enrolled in Medi-Cal through previous expansions to residents lacking authorization. The change is expected to add over 700,000 first-time enrollees.

Readers Slam Hospital Monopolies and Blame the Feds for Understaffed Nursing Homes
KFF Health News gives readers a chance to comment on a recent batch of stories.

An Arm and a Leg: When Hospitals Sue Patients (Part 1)
By Dan Weissmann Some hospitals sue patients over unpaid medical bills. But is this even an effective way for hospitals to recoup lost revenue? On this episode of “An Arm and a Leg,” host Dan Weissmann speaks with medical-debt experts to explore a different solution.

‘Financial Ruin Is Baked Into the System’: Readers on the Costs of Long-Term Care
By Jordan Rau and Reed Abelson, The New York Times Thousands of people shared their experiences and related to the financial drain on families portrayed in the “Dying Broke” series, a joint project by KFF Health News and The New York Times that examined the costs of long-term care.

Más estados amplían cobertura de salud para inmigrantes sin papeles, en medio de crisis en la frontera
By Phil Galewitz La mayoría de los adultos sin papeles trabajan, representan aproximadamente el 5% de la fuerza laboral nacional, según el Pew Research Center.

Se avecinan cambios para Medi-Cal en 2024, pero ¿beneficiarán a los pacientes?
By Bernard J. Wolfson A partir del próximo año, más de 700,000 inmigrantes sin papeles serán elegibles para una cobertura completa de Medi-Cal.

A partir del 1 de enero, todos los inmigrantes en California pueden calificar para Medi-Cal, más allá de su estatus legal
By Bernard J. Wolfson Los nuevos inscritos se sumarán a más de 655,000 niños, adultos jóvenes de hasta 25 años y adultos de 50 años y más que ya se han registrado en Medi-Cal a través de expansiones anteriores para residentes sin papeles.

Adultos mayores, detectives contra avisos engañosos de Medicare Advantage
By Susan Jaffe Funcionarios de los Centros de Servicios de Medicare y Medicaid le han pedido a las personas mayores y a otros miembros de la comunidad que sean detectives contra el fraude, denunciando tácticas de venta engañosas al 800-MEDICARE.