KHN Weekly Edition: Nov. 18, 2022

Path Cleared for Georgia to Launch Work Requirements for Medicaid
By Andy Miller and Sam Whitehead Federal officials have apparently stopped fighting Georgia’s plan for a limited Medicaid expansion that includes work requirements. The plan, a key policy of Republican Gov. Brian Kemp’s, would cover a much smaller portion of the population: those who can work or volunteer 80 hours a month.

As STDs Proliferate, Companies Rush to Market At-Home Test Kits. But Are They Reliable?
By Liz Szabo Photos by Eric Harkleroad The popularity of at-home covid tests has amplified calls from public health researchers and diagnostic companies to make home testing similarly routine for sexually transmitted diseases. But FDA guidelines are lagging.

Mistrust and Polarization Steer Rural Governments to Reject Federal Public Health Funding
By Jazmin Orozco Rodriguez As the covid-19 pandemic grinds on, Elko County, Nevada, still lacks a public health department. Yet its elected leaders rejected federal funds that could have helped it create one. Decisions like the one in Elko, and ones made by officials with other state and local governments, leave health experts concerned about whether the country's public health infrastructure will be prepared to handle future health challenges.

‘An Arm and a Leg’: No Money, No Job, No Health Care? Not Always.
By Dan Weissmann For many Americans, it’s open enrollment season for 2023 health insurance. One listener asked: If you don’t have a job and are too old to be on your parents’ plan, does it make sense to rely on charity care? This episode breaks it all down.

‘Impending Intergenerational Crisis’: Americans With Disabilities Lack Long-Term Care Plans
By Sam Whitehead Many Americans with intellectual and developmental disabilities do not have long-term plans for when family members can no longer care for them. Families, researchers, and advocates worry that has set the stage for a crisis in which people with disabilities could end up living in institutional settings.

Journalists Tackle the Midterms and Open Enrollment
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.

Sick Profit: Investigating Private Equity’s Stealthy Takeover of Health Care Across Cities and Specialties
By Fred Schulte Private equity firms have shelled out almost $1 trillion to acquire nearly 8,000 health care businesses, in deals almost always hidden from federal regulators. The result: higher prices, lawsuits, and complaints about care.

Thousands of Experts Hired to Aid Public Health Departments Are Losing Their Jobs
By Lauren Weber As the covid-19 pandemic raged, an independent nonprofit tied to the Centers for Disease Control and Prevention hired an army of seasoned professionals to fill the gaps in the country’s public health system. Now, the money has largely run out, and state and local health departments are again without their expertise.

California Stockpiles Penalties From Uninsured Residents Instead of Lowering Care Costs
By Angela Hart California is collecting hundreds of millions of dollars a year in tax penalties from uninsured residents. The state was supposed to use the money to help lower costs for Californians who couldn’t afford insurance but hasn’t distributed any of the revenue it has collected — citing uncertain economic times.

Blackfeet Nation Challenges Montana Ban on Vaccine Mandates as Infringement on Sovereignty
By Katheryn Houghton The Montana tribe has entered a legal fight over whether the state has the right to enforce a prohibition of vaccine mandates on its reservation.

Watch: As Health Costs Spike, the Role of Hospitals Often Gets Overlooked
A new documentary, “InHospitable,” explores how disputes between big hospitals can leave patients with few options for care and imperil their health.

Medicare Plan Finder Likely Won’t Note New $35 Cap on Out-of-Pocket Insulin Costs
By Susan Jaffe In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.

Patients Complain Some Obesity Care Startups Offer Pills, and Not Much Else
By Darius Tahir A new wave of obesity care startups offer access to new weight loss medications. But do they offer good health care?

How Optimism Can Close the Medicaid Coverage Gap
By Phil Galewitz and Daniel Chang Low-income residents in states that haven’t expanded Medicaid are in a tough spot: They don’t qualify for the subsidies that people with slightly higher incomes get to buy marketplace plans because of a glitch in the federal health law. But a court decision last year makes it easier for them to make good-faith estimates of a pay increase, and there is no financial penalty if they don’t hit that figure.

The Player-Coaches of Addiction Recovery Work Without Boundaries
By Rae Ellen Bichell States, tribes, and local governments are figuring out how best to spend billions of dollars from an opioid lawsuit settlement. One option they’re considering is funding peer support specialists, who guide people recovering from addiction as they do it themselves.

Fight Over Health Care Minimum Wage Yields a Split Decision in Southern California
By Rachel Bluth Voters in Inglewood were poised to approve a union-backed $25 minimum wage for workers at private hospitals and facilities, while Duarte voters rejected it.

How Banks and Private Equity Cash In When Patients Can’t Pay Their Medical Bills
By Noam N. Levey and Aneri Pattani Hospitals strike deals with financing companies, generating profits for lenders, and more debt for patients.

KHN’s ‘What the Health?’: The Changing of the Guard
Democrats retained control of the U.S. Senate in the midterm elections, while Republicans won a majority in the House, giving them the ability to block items on President Joe Biden’s agenda. Meanwhile, the lame-duck, Democratic-led Congress won’t have the votes to pass abortion rights legislation, although they may try to undo some long-standing anti-abortion policies in federal spending bills. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Victoria Knight of Axios, and Alice Miranda Ollstein of Politico, join KHN’s Julie Rovner to discuss these topics and more.