Insurance, Coverage, and Costs: Nov. 2, 2023
When That Supposedly Free Annual Physical Generates a Bill
By Julie Appleby
Completing a routine depression screening questionnaire during an annual checkup is cost-free under federal law. But, as one woman discovered, answering a doctor’s follow-up questions might not be.
She Received Chemo in Two States. Why Did It Cost So Much More in Alaska?
By Arielle Zionts
A breast cancer patient who received similar treatments in two states saw significant differences in cost, illuminating how care in remote areas can come with a stiffer price tag.
Street Medicine Practitioners Are Getting Paid. Now They Want Higher Rates.
By Angela Hart
Street medicine, the practice of caring for homeless people outdoors, is a burgeoning field — an unfortunate reality as America confronts a growing homelessness epidemic. But it’s at least become a little more rewarding after the Biden administration made an under-the-radar yet revolutionary change to Medicaid. Starting this month, doctors, nurses and other providers can bill […]
Covid Relief Payments Triggered Feds to Demand Money Back From Social Security Recipients
By David Hilzenrath and Jodie Fleischer, Cox Media Group
Some Social Security beneficiaries say the government is clawing back benefits after they received covid stimulus payments that were supposed to be exempt from asset limits.
Senators Demand Answers From Social Security on Clawbacks Tied to Covid Relief
By David Hilzenrath and Jodie Fleischer, Cox Media Group
Covid relief payments weren’t supposed to cost people their Social Security benefits, but some recipients say they did. Senators want to know why.
Under Fire, Social Security Chief Vows ‘Top-to-Bottom’ Review of Payment Clawbacks
By David Hilzenrath and Jodie Fleischer, Cox Media Group
Acting Commissioner Kilolo Kijakazi was pressed by a House Ways and Means subcommittee to explain why so many poor, disabled, or retired people are suddenly hit with demands that can reach tens of thousands of dollars or more.
A New Era of Vaccines Leaves Old Questions About Prices Unanswered
By Elisabeth Rosenthal
The CDC’s RSV vaccination recommendations beg the question: How much should an immunization that will possibly be given to millions of Americans cost to be truly valuable?
Using Opioid Settlement Cash for Police Gear Like Squad Cars and Scanners Sparks Debate
By Aneri Pattani
State and local governments will receive a windfall of more than $50 billion over 18 years from settlements with companies that made, sold, or distributed opioid painkillers. Using the funds for law enforcement has triggered important questions about what the money was meant for.
California Expands Paid Sick Days and Boosts Health Worker Wages
By Don Thompson
Gov. Gavin Newsom signed legislation expanding paid sick leave to five days, extending bereavement leave to miscarriages and failed adoptions, and approving an eventual $25-an-hour health care minimum wage. Still, in a possible sign of national ambitions, the Democrat vetoed free condoms in schools and refused to decriminalize psychedelic mushrooms.
The AMA May Reconsider Single-Payer Health Care
By Julie Rovner
Is the American Medical Association going soft on single-payer health care? We’re about to find out. For more than a century, the most influential U.S. physician group has stridently opposed what could generally be described as “national health insurance.” It famously helped defeat health reform efforts in the 1930s and 1940s, delayed the establishment of […]
Facing Criticism, Feds Award First Maternal Health Grant to a Predominantly Black Rural Area
By Sarah Jane Tribble
Mississippi has the highest rate of maternal mortality in the U.S. Now, it also has a federal grant to help in rural areas. The award could signal more flexibility from federal officials.
These Appalachia Hospitals Made Big Promises to Gain a Monopoly. They’re Failing to Deliver.
By Brett Kelman and Samantha Liss
Ballad Health, the only hospital system across a large swath of Tennessee and Virginia, has fallen short of quality-of-care and charity care obligations — even as it’s sued thousands of patients for unpaid bills.
‘Worse Than People Can Imagine’: Medicaid ‘Unwinding’ Breeds Chaos in States
By Phil Galewitz and Katheryn Houghton and Brett Kelman and Samantha Liss
As Medicaid programs across the nation review enrollees' status in the wake of the pandemic, patients struggle to navigate the upheaval.
KFF Health News' 'What the Health?': The Open Enrollment Mixing Bowl
Open enrollment for Medicare beneficiaries with private health plans began Oct. 15, to be followed Nov. 1 by open enrollment for Affordable Care Act plans. The selection for both is large — often too large to be navigated easily alone. And people who choose incorrectly can end up with unaffordable medical bills. Meanwhile, those on both sides of the abortion issue are looking to Ohio’s November ballot measure on abortion to see whether anti-abortion forces can break their losing streak in statewide ballot questions since the overturn of Roe v. Wade in 2022.
Start Shopping: Enrollment Begins Nov. 1 for Most Obamacare Insurance Plans
By Julie Appleby
More than 16 million Americans who buy their own health insurance through state and federal marketplaces have until Jan. 15 to compare prices, change their coverage, or enroll for the first time.
Quick Genetic Test Offers Hope for Sick, Undiagnosed Kids. But Few Insurers Offer to Pay.
By Phil Galewitz
A new, rapid genetic test shows promise in increasing diagnoses and improving treatment for some children with rare genetic conditions. Many insurers won’t cover it, but Florida's Medicaid program is among those that see benefits — and, potentially, savings.
Smaller Employers Weigh a Big-Company Fix for Scarce Primary Care: Their Own Clinics
By Phil Galewitz
Company health clinics are most common at large workplaces, but some small employers say they see advantages, too: healthier workers, lower costs, and better access to primary care.
Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
By Susan Jaffe
Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
Medicare Enrollees Can Switch Coverage Now. Here’s What’s New and What to Consider.
By Julie Appleby
Fall is the time when enrollees in the federal program for older people and people with certain disabilities can make changes to their health and drug plans. The decision can be complicated, but here are some key points to keep in mind.
Tiny, Rural Hospitals Feel the Pinch as Medicare Advantage Plans Grow
By Sarah Jane Tribble
More than half of seniors are enrolled in private Medicare Advantage plans instead of traditional Medicare. Rural enrollment has increased fourfold and many small-town hospitals say that threatens their viability.
Abortion Coverage Is Limited or Unavailable at a Quarter of Large Workplaces
By Rachana Pradhan
A KFF survey of employer health benefits shows that 28% of large U.S. companies have limited or no access to abortion under company health insurance.
Es el momento de revisar el plan de Medicare. Lo nuevo que hay que saber
By Julie Appleby
Desde el 15 de octubre y hasta el 7 de diciembre, los afiliados al programa tradicional o a los planes de Medicare Advantage, que ofrecen aseguradoras privadas, pueden cambiar su cobertura.
Nuevos planes de Medicare Advantage adaptan ofertas para asiáticos, latinos y LGTBQ+
By Stephanie Stephens
A medida que Medicare Advantage gana popularidad entre los adultos mayores, tres compañías del sur de California están lanzando nuevos planes que se enfocan en comunidades culturales y étnicas, con ofertas especiales y profesionales que hablan su idioma nativo.
Pruebas genéticas rápidas a bebés pueden salvar vidas, pero muchas aseguradoras no las cubren
By Phil Galewitz
Que Medicaid cubra la prueba puede expandir significativamente el acceso para los bebés; el programa de salud federal gerenciado por los estados que asegura a las familias de bajos ingresos y que cubre a más del 40% de los niños en su primer año de vida.
Comienza la inscripción para los seguros de salud del Obamacare
By Julie Appleby
Los consumidores pueden ir en línea, llamar o buscar ayuda de un corredor, o un navegador, para conocer sus opciones de cobertura para 2024, calcular sus posibles subsidios o cambiar de plan.