KHN Weekly Edition: Dec. 23, 2021

Record Number of Americans Sign Up for ACA Health Insurance
By Phil Galewitz and Andy Miller Nearly 14 million Americans have enrolled in Affordable Care Act marketplace health plans for next year — a record since the health law’s coverage expansion took effect in 2014. A boost in subsidies marketing and assistance in navigating the process increased the rolls of the insured.

Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert
By Markian Hawryluk Predominantly Black and Hispanic urban areas are more likely than white neighborhoods to see local pharmacies close and are more likely to be pharmacy deserts. In Chicago, one pharmacist is bucking the trend, operating the drugstore his father opened in the 1960s in a Black neighborhood.

Local Pharmacists Fill Rx Void as Big Brands Pull Out of Rural Areas
By Markian Hawryluk Stores like Walmart and Shopko opened pharmacies in small towns, either buying out the local pharmacy or driving it out of business. What happens when those chains later withdraw, leaving communities with no pharmacy?

Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby
By Andy Miller Rural areas such as Echols County, Georgia, have high levels of uninsured people and profound physician shortages that compound the lack of health care options, especially in the 12 states that have not expanded Medicaid.

As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short
By Lauren Weber and Christina Jewett Photos by Heidi de Marco A KHN investigation finds that hospitals with high rates of covid patients who didn’t have the diagnosis when they were admitted have rarely been held accountable due to multiple gaps in government oversight.

As Pandemic Wears Down Hospital Staff, One Town Offers Groceries to Say Thanks
By Daryl Austin To help relieve the stress and time strains on employees at a Park City, Utah, hospital, community leaders created a pop-up grocery store, where workers can get complimentary meals and staples to take home.

Vaccine Promoters Struggle to Get People Boosted in California’s Fields
By Heidi de Marco Stressed vaccine communicators battle anti-vaccine propaganda while seeking to persuade Latino farmworkers to get covid boosters.

The Vaccine Rollout Was a Success. But Events Within and Beyond Biden’s Control Stymied Progress.
By Victoria Knight There were variants, vaccine hesitancy and messaging mix-ups. And, despite campaign promises, Biden and his administration sometimes took actions or made statements without waiting for full scientific evidence to back them up.

Pandemic Poses Short- and Long-Term Risks to Babies, Especially Boys
By Liz Szabo A mother’s immune response to covid can be a greater danger to the fetus than the virus itself.

Some Groups Are Left Out of Montana Covid Test Giveaway Program
By Mara Silvers, Montana Free Press and Katheryn Houghton Public health officials and policymakers alike see rapid antigen tests as a strong tool to keep businesses open and parents working. But a look at Montana’s distribution of the tests shows a patchwork system with limited access for many.

Watch: One City’s Effort to Raise Vaccination Rates Among Black Residents
By Sarah Varney and Jason Kane, PBS NewsHour In Hartford, Connecticut, public health leaders engage barbers and faith leaders to combat vaccine skepticism in the Black community.

‘An Arm and a Leg’: The Rapid-Test Edition: Who’s Making a Buck?
By Dan Weissmann In this episode, host Dan Weissmann talks to reporters who investigated the shortage of tests and traced the U.S. rapid-testing problem back to government agencies.

NICU Bill Installment Plan: That’ll Be $45,843 a Month for 12 Months, Please
By Victoria Knight After baby Dorian Bennett arrived two months early and spent more than 50 days in the neonatal ICU, his parents received a bill of more than $550,000 — despite having insurance. The Florida hospital had a not-so-helpful suggestion: monthly payments of more than $45,000 for a year.

New Parents Slapped With Surprise Bills for Treating Newborns
By Jay Hancock Regular use of a more advanced screening method turns a low-cost procedure into a pricier one.

Crash Course: Injured Patients Who Sign ‘Letters of Protection’ May Face Huge Medical Bills and Risks
By Fred Schulte The letters function as liens that “protect” spine surgery clinics while patients could be left with inflated medical bills and unexpected health risks.

An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills
By Jay Hancock Legislative crackdowns on out-of-network bills haven’t kept specialists from hitting patients with unexpected charges running into thousands of dollars.

Layers of Subcontracted Services Confuse and Frustrate Medi-Cal Patients
By Bernard J. Wolfson Many of the 14 million patients in Medi-Cal are in managed care health plans that outsource their care to subcontractors or sub-subcontractors. For patients with difficult health care needs, it can be hard to know where to turn.

Covered California’s Insurance Deals Range From ‘No-Brainer’ to Sticker Shock
By Bernard J. Wolfson Families of four with incomes of less than about $40,000 a year can pay no premiums and have low deductibles. For some others, health insurance in 2022 will cost more than in 2021 — in some cases, significantly more.

Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages
By Sarah Varney Add nursing homes to the list of industries jolted by Amazon’s handsome hourly wages. Enticed by an average starting pay rate of $18 an hour and the potential for benefits and signing bonuses, low-wage workers are fleeing entry-level elder care for jobs packing boxes.

KHN’s ‘What the Health?’: Manchin Blows Up Biden’s ‘Build Back Better’
Sen. Joe Manchin (D-W.Va.) dealt a blow to congressional efforts to pass President Joe Biden’s domestic agenda bill, forcing Democrats to regroup starting in 2022. Meanwhile, the omicron covid variant spreads rapidly in the U.S., threatening the stability of the nation’s health care system. Joanne Kenen of Politico and the Johns Hopkins School of Public Health, Rachel Cohrs of Stat and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these issues and more, plus a look back at the year in health policy. Also this week, Rovner interviews Ceci Connolly, president and CEO of the Alliance of Community Health Plans.

Journalists Review Public Views on Vaccines and the Arc of Covid Testing
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.