Insurance, Coverage, and Costs: July 25, 2025

An Arm and a Leg: The Woman Who Beat an $8,000 Hospital Fee
By Dan Weissmann In this episode of “An Arm and a Leg,” host Dan Weissmann speaks with Georgann Boatright, a patient in Mississippi who was willing to drive to another state to avoid paying a steep fee to her local hospital.

Oregon Senator Proposes Criminal Charges and Fines for Rogue Obamacare Agents
By Julie Appleby Oregon Sen. Ron Wyden introduced legislation intended to curb a growing problem in which consumers, without their consent, are enrolled in Affordable Care Act plans or their coverage is switched.

Harris, Once Biden’s Voice on Abortion, Would Take an Outspoken Approach to Health
By Stephanie Armour and Julie Appleby and Julie Rovner If she grabs the baton from President Joe Biden to become the new presumptive Democratic presidential nominee, Kamala Harris would widely be expected to take an aggressive stance in support of abortion access — hitting former President Donald Trump on an issue that could undermine his chances of victory.

Biden Administration Tightens Broker Access to Healthcare.gov To Thwart Rogue Sign-Ups
By Julie Appleby The Centers for Medicare & Medicaid Services said it has received more than 200,000 complaints in the first six months of the year about people being signed up for Obamacare plans or switched to new plans without their consent.

At Trump’s GOP Convention, There’s Little To Be Heard on Health Care
By Phil Galewitz Republicans were once the party of Obamacare repeal and abortion opposition. They’ve said little about either issue in Milwaukee.

Misleading Ads Play Key Role in Schemes to Gin Up Unauthorized ACA Sign-Ups, Lawsuit Alleges
By Julie Appleby Misleading money-for-groceries ads helped lure people to call centers where some were enrolled in Affordable Care Act coverage — or switched from their existing plans — without their express permission, a new lawsuit alleges.

Her Hearing Implant Was Preapproved. Nonetheless, She Got $139,000 Bills for Months.
By Elisabeth Rosenthal Even when patients double-check that their care is covered by insurance, health providers often send them bills as they haggle with insurers over reimbursement, which can last for months. It’s stressful and annoying — but legal.

HealthSherpa and Insurers Team Up To Curb Unauthorized ACA Enrollment Schemes
By Julie Appleby The initiative targets the biggest incentive driving fraudulent sign-ups and plan switches: the commissions that rogue agents or large call centers seek.

California Health Care Pioneer Goes National, Girds for Partisan Skirmishes
By Samantha Young Anthony Wright, a champion for Californians’ health care rights, will take the helm of Families USA in Washington, D.C., where he plans to campaign for more affordable and accessible care nationally. He leaves Health Access California, where he helped outlaw surprise medical billing, require companies to report drug price increases, and cap hospital bills for uninsured patients.

‘A Bottomless Pit’: How Out-of-Pocket TMJ Costs Drive Patients Into Debt
By Brett Kelman and Anna Werner, CBS News Millions of Americans suffer from temporomandibular joint, or TMJ, disorders. The high cost and poor insurance coverage of TMJ care can bury patients in debt even as the treatments do more harm than good.

If Lawsuit Ends Federal Mandates on Birth Control Coverage, States Will Have the Say
By Sam Whitehead An ongoing lawsuit aims to set aside the Affordable Care Act’s requirements that insurers cover preventive care, such as contraception. If that happens, state reproductive health laws — varying across the country — would carry more weight, resuming the “wild West” dynamic from before Obamacare.

Lack of Affordability Tops Older Americans’ List of Health Care Worries
By Judith Graham Rising health care costs are fueling anxiety among older Americans covered by Medicare. They’re right to be concerned.

States Set Minimum Staffing Levels for Nursing Homes. Residents Suffer When Rules Are Ignored or Waived.
By Jordan Rau The Biden administration set stringent new federal staffing rules. But for years, nursing homes have failed to meet the toughest standards set by states.

The Concierge Catch: Better Access for a Few Patients Disrupts Care for Many
By John Rossheim Increasingly, Americans pay for the privilege of seeing a doctor. Research shows concierge medicine can further hamper access to care for those who can’t afford the upgrade.

A California Medical Group Treats Only Homeless Patients — And Makes Money Doing It
By Angela Hart Healthcare in Action, a California medical group that exclusively serves homeless people, has tapped into growing demand and funding for street medicine services. Three years in, the innovative nonprofit is raking in revenue and serving thousands of people who otherwise might flock to the hospital for high-cost care.

Trump Is Wrong in Claiming Full Credit for Lowering Insulin Prices
By Jacob Gardenswartz Though the Trump administration established a voluntary, temporary program lowering insulin costs for some older Americans on Medicare, the mandatory price caps implemented through Biden’s Inflation Reduction Act go significantly further.

Colorado Dropped Medicaid Enrollees as Red States Have, Alarming Advocates for the Poor
By Rae Ellen Bichell Colorado defended its high disenrollment rates following the covid crisis by saying that what goes up must come down. Advocates and researchers disagree.

Harris, alguna vez la voz de Biden sobre el aborto, tendría un enfoque abierto en temas de salud
By Stephanie Armour and Julie Appleby and Julie Rovner Mientras los demócratas reconstruyen su candidatura presidencial a pocos meses de las elecciones, se esperaría que, de ser la nueva nominada, Harris adoptase una postura agresiva en apoyo al acceso al aborto y en otros temas controversiales de salud.

En la convención republicana de Trump se escuchó poco y nada sobre atención de salud
By Phil Galewitz La atención médica constituye la mayor parte del presupuesto federal, casi $2 mil millones, así como el 17% de la producción económica del país.