Insurance Coverage & Costs: Feb. 3, 2022
The Doctor Didn’t Show Up, but the Hospital ER Still Charged $1,012
Noam N. Levey
A St. Louis-area toddler burned his hand on the stove, and his mom took him to the ER on the advice of her pediatrician. He wasn’t seen by a doctor, and the dressing on the wound wasn’t changed. The bill was more than a thousand dollars.
Watch: ER Charged $1,012 for Almost No Care
KHN Editor-in-Chief Elisabeth Rosenthal weighs in on the January installment of KHN-NPR's Bill of the Month, in which a family gets burned over a visit to the emergency room.
Why Medicare Doesn’t Pay for Rapid At-Home Covid Tests
Michelle Andrews
The laws governing Medicare don’t provide coverage for self-administered diagnostic tests, which is precisely what the rapid antigen tests are and why they are an important tool for containing the pandemic.
5 Things You Should Know About ‘Free’ At-Home Covid Tests
Damon Darlin
Telling insurance companies to pay for rapid covid-19 tests is just the latest covid-related cost the federal government expects them to bear. But who really ends up paying for it?
States Were Sharing Covid Test Kits. Then Omicron Hit.
Katheryn Houghton
The omicron variant upended a system in which states shared rapid covid tests with those that needed them more. Cooperation has turned into competition as states run out of supplies, limit which organizations get them, or hold on to expired kits as a last resort.
Biden Administration’s Rapid-Test Rollout Doesn’t Easily Reach Those Who Need It Most
Hannah Recht and Victoria Knight
Two rapid-testing initiatives the Biden administration released in the past week are inaccessible to some residents of multifamily housing, people who don’t speak English well, or those without internet access.
South Dakota Voters to Decide Medicaid Expansion
Phil Galewitz
Despite state Republican leaders’ rigid opposition to expanding the health program designed for low-income residents, advocates successfully gathered enough signatures to get the measure on the fall ballot.
HHS Proposal for Marketplace Plans Carries a Hefty Dose of Consumer Caution
Julie Appleby
The Department of Health and Human Services issued preliminary rules regarding health insurance marketplaces that aim to deter fraudulent sign-ups for coverage. Experts say the agency’s action indicates a problem exists.
Medicare Patients Win the Right to Appeal Gap in Nursing Home Coverage
Susan Jaffe
If federal officials accept a court’s decision, some patients will get a chance to seek refunds for their nursing home and other expenses.
Georgia Bill Aims to Limit Profits of Medicaid Managed-Care Companies
Andy Miller and Rebecca Grapevine
Georgia lawmakers unveiled a mental health bill that would limit the profits of the managed-care companies that serve Medicaid patients. KHN previously reported that Georgia, unlike most states, does not set a medical loss ratio for the companies’ spending on medical care and quality improvements.
I Write About America’s Absurd Health Care System. Then I Got Caught Up in It.
Bram Sable-Smith
A KHN reporter had written for years about the people left behind by the absurdly complex and expensive U.S. health care system. Then he found himself navigating that maze as he tried to get his insulin prescription filled.
After Miscarriages, Workers Have Few Guarantees for Time Off or Job-Based Help
Bryce Covert
About a quarter of all pregnancies end in miscarriage. Despite the large number of workers affected, no national laws protect them when they need time off to deal with the loss.
Resistance to a Boston Hospital’s Expansion Centers on Rising Prices
Harris Meyer
Mass General Brigham’s $2.3 billion expansion plan is raising state officials’ concerns that it will reduce competition and raise the price of care in Massachusetts. It also signals a national shift from a focus on hospital mergers and purchases of physician practices — which boost the cost of care — to individual hospitals’ expansions to gain a bigger share of the market.
App Attempts to Break Barriers to Bankruptcy for Those in Medical Debt
Blake Farmer, Nashville Public Radio
Medical bills are a leading reason people get stuck in a cycle of debt. Declaring bankruptcy is one lifeline, but attorney and court fees can put it out of reach. The nonprofit Upsolve created an app it calls the “TurboTax of bankruptcy” to help people hit the reset button and rebuild their financial lives.
Long-Excluded Uterine Cancer Patients Are a Step Closer to 9/11 Benefits
Erica Hensley
More than 20 years after the terrorist attacks, the World Trade Center Health Program is considering covering the most common form of uterine cancer, in what patient advocates say is a key acknowledgment of the women affected by the 9/11 fallout.
What the Federal ‘No Surprises Act’ Means in California
Bernard J. Wolfson
The new federal law will provide protection against surprise medical bills for between 6 million and 7 million Californians who are not covered under state law.
‘An Arm and a Leg’: Know Your ‘No Surprises’ Rights
Dan Weissmann
The No Surprises Act protects patients from surprise out-of-network bills. But there are caveats. For instance, these protections apply only to care in a hospital. This episode breaks it all down.
KHN’s ‘What the Health?’: Record ACA Enrollment Puts Pressure on Congress
Temporary subsidies helped boost enrollment under the Affordable Care Act to a record 14.5 million, according to the Department of Health and Human Services. But unless Democrats in Congress extend those subsidies, many of those new enrollees will be in for a rude surprise just ahead of midterm elections. Meanwhile, the need to replace retiring Supreme Court Justice Stephen Breyer further crowds an already tight legislative schedule. Joanne Kenen of Politico and the Johns Hopkins Bloomberg School of Public Health, Sarah Karlin-Smith of the Pink Sheet, and Anna Edney of Bloomberg News join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Diana Greene Foster, author of “The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having — Or Being Denied — An Abortion.”
KHN’s ‘What the Health?’: Contagion Confusion
It’s 2022 and the covid-19 pandemic is still with us, as are congressional efforts to pass President Joe Biden’s big health and social spending bill. But other issues seem certain to take center stage on this year’s health agenda, including abortion, the state of the health care workforce, and prescription drug prices. Tami Luhby of CNN, Alice Miranda Ollstein of Politico and Mary Ellen McIntire of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KHN’s Victoria Knight, who reported the latest KHN-NPR “Bill of the Month” episode.
KHN’s ‘What the Health?’: Dealing With Drug Prices
Medicare officials tentatively plan to restrict the use of a controversial Alzheimer’s drug to only those patients participating in clinical trials, while the Department of Health and Human Services looks into lowering the monthly Medicare Part B premium. Meanwhile, covid confusion still reigns, as the Biden administration moves, belatedly, to make more masks and tests available. Joanne Kenen of Politico and the Johns Hopkins Bloomberg School of Public Health, Sarah Karlin-Smith of the Pink Sheet and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these issues and more.
Listen: Generous Deals, and a Few Unwanted Surprises, at Covered California
Southern California correspondent Bernard J. Wolfson answers questions about the health coverage deals available on California’s Affordable Care Act marketplace during Radio Bilingüe’s news program “Línea Abierta.”
Listen: How the New ‘No Surprises’ Law Tackles Unexpected Medical Bills
Years in the making, a new federal law against surprise medical bills took effect Jan. 1.
Readers and Tweeters: Give Nurse Practitioners Their Due
KHN gives readers a chance to comment on a recent batch of stories.
¿Por qué Medicare no paga por las pruebas caseras para covid?
Michelle Andrews
Las mismas leyes del programa para los adultos mayores previenen que puedan comprar medicamentos de venta libre y obtener este tipo de pruebas sin una orden médica.
Cinco cosas que deberías saber sobre las pruebas caseras “gratis” para covid
Damon Darlin
Los estadounidenses siguen escuchando que es importante hacerse pruebas caseras para covid con frecuencia. El problema es encontrar tests que sean lo suficientemente asequibles para poder comprarlos a menudo.
Aplicación ayuda a desestigmatizar la bancarrota para afrontar cuentas médicas
Blake Farmer, Nashville Public Radio
Casi uno de cada 5 hogares en los Estados Unidos está en apuros por cuentas médicas atrasadas, según la Oficina del Censo. Las minorías son las más afectadas.
Después de un aborto espontáneo, trabajadoras no tienen ni tiempo libre ni ayuda de las empresas
Bryce Covert
El aborto espontáneo, que se produce en una cuarta parte de los embarazos, es la forma más común de pérdida de un embarazo. Y, sin embargo, no hay leyes nacionales que protejan a las personas cuando necesitan tomarse un tiempo para afrontar la pérdida.
El plan de Biden para entregar pruebas gratis para covid no llega fácilmente a los más vulnerables
Hannah Recht and Victoria Knight
Desde el límite establecido en los pedidos de prueba hasta los idiomas disponibles en los sitios web, los programas pueden dejar fuera a muchas personas que no hablan inglés o no tienen acceso a Internet, así como a las que viven en hogares multigeneracionales.