Medicare and Aging: April 11, 2024
Attack of the Medicare Machines
Dan Weissmann
In this episode of “An Arm and a Leg,” host Dan Weissmann tells a horror story. Instead of monsters and aliens, it’s about private health insurance companies and algorithms that call the shots on patient care.
Rising Complaints of Unauthorized Obamacare Plan-Switching and Sign-Ups Trigger Concern
Julie Appleby
Federal and state regulators are mulling what they can do to thwart this growing problem.
Biden Is Right About $35 Insulin Cap but Exaggerates Prior Costs for Medicare Enrollees
Samantha Putterman, PolitiFact
Most Medicare enrollees likely were not paying a monthly average of $400 — as President Joe Biden stated — before the insulin cap took effect. However, because costs and other factors result in widely varying prices, some Medicare enrollees might have paid that much in a given month.
Florida Limits Abortion — For Now
The Florida Supreme Court handed down dual abortion rulings this week. One said voters will be allowed to decide in November whether to create a state right to abortion. The other ruling, though, allows a 15-week ban to take effect immediately — before an even more sweeping, six-week ban replaces it in May. Meanwhile, President Joe Biden is doubling down on his administration’s health care accomplishments as he kicks off his general election campaign. Lauren Weber of The Washington Post, Joanne Kenen of the Johns Hopkins University schools of nursing and public health, and Tami Luhby of CNN join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews health care analyst Jeff Goldsmith about the growing size and influence of UnitedHealth Group in the wake of the Change Healthcare hack.
ACA Plans Are Being Switched Without Enrollees’ OK
Julie Appleby
Insurance agents say it’s too easy to access consumer information on the Affordable Care Act federal marketplace. Policyholders can lose their doctors and access to prescriptions. Some end up owing back taxes.
Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
Susan Jaffe
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
The Supreme Court and the Abortion Pill
The Supreme Court this week heard its first abortion case since overturning Roe v. Wade in 2022, about an appeals court ruling that would dramatically restrict the availability of the abortion pill mifepristone. But while it seems likely that this case could be dismissed on a technicality, abortion opponents have more challenges in the pipeline. Meanwhile, health issues are heating up on the campaign trail, as Republicans continue to take aim at Medicare, Medicaid, and the Affordable Care Act — all things Democrats are delighted to defend. Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet, and Lauren Weber of The Washington Post join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KFF Health News’ Tony Leys, who wrote a KFF Health News-NPR “Bill of the Month” feature about Medicare and a very expensive air-ambulance ride. Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too.
The Burden of Getting Medical Care Can Exhaust Older Patients
Judith Graham
It’s estimated that an older patient can spend three weeks of the year getting care — and that doesn’t count the time it takes to arrange appointments or deal with insurance companies.
The ACA Turns 14
Saturday marks the 14th anniversary of the still somewhat embattled Affordable Care Act. Health and Human Services Secretary Xavier Becerra joins host Julie Rovner to discuss the accomplishments of the health law — and the challenges it still faces. Also this week, Alice Miranda Ollstein of Politico, Tami Luhby of CNN, and Mary Agnes Carey of KFF Health News join Rovner to discuss what should be the final funding bill for HHS for fiscal 2024, next week’s Supreme Court oral arguments in a case challenging abortion medication, and more. Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too.
Biden Said Medicare Drug Price Negotiations Cut the Deficit by $160B. That’s Years Away.
Amy Sherman, PolitiFact
Savings estimated by the Congressional Budget Office from allowing the federal government to negotiate Medicare drug prices are based on a 10-year cumulative projection.
Telehealth Sites Promise Cure for ‘Male Menopause’ Despite FDA Ban on Off-Label Ads
Michael Scaturro
Most healthy men produce sufficient testosterone as they age. Yet online ads and telehealth sites are promoting testosterone drugs with flawed promises of boosting libido and busting stomach fat.
Covid and Medicare Payments Spark Remote Patient Monitoring Boom
Phil Galewitz and Holly K. Hacker
Demand for help monitoring patients’ vital signs remotely has taken off since a Medicare change in 2019. Dozens of companies now push the service to help overburdened primary care doctors — and as a revenue stream. But some policy experts say its growth has outpaced oversight and evidence of effectiveness.
Maybe It’s a Health Care Election After All
Health care wasn’t expected to be a major theme for this year’s elections. But as President Joe Biden and former President Donald Trump secured their respective party nominations this week, the future of both Medicare and the Affordable Care Act appears to be up for debate. Meanwhile, the cyberattack of the UnitedHealth Group subsidiary Change Healthcare continues to do damage to the companies’ finances with no quick end in sight. Margot Sanger-Katz of The New York Times, Anna Edney of Bloomberg News, and Joanne Kenen of Johns Hopkins University and Politico Magazine join KFF Health News’ Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Kelly Henning of Bloomberg Philanthropies about a new, four-part documentary series on the history of public health, “The Invisible Shield.” Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too.
How Primary Care Is Being Disrupted: A Video Primer
Julie Appleby and Hannah Norman and Oona Zenda
Under pressure from increased demand, consolidation, and changing patient expectations, the model of care no longer means visiting the same doctor for decades.
Some Medicaid Providers Borrow or Go Into Debt Amid ‘Unwinding’ Payment Disruptions
Katheryn Houghton
Used to operating with scarce resources, Montana Medicaid providers say gaps in state payments have left them struggling further.
Social Security Chief Testifies in Senate About Plans to Stop ‘Clawback Cruelty’
David Hilzenrath and Jodie Fleischer, Cox Media Group and Eric Harkleroad
Commissioner Martin O’Malley testifies to two Senate panels that his agency will stop the “injustices” of suspending people’s monthly benefits to recover alleged overpayments. The burden will be on the Social Security Administration to prove the beneficiary was to blame.
Adultos mayores, agotados por tener que organizar tanta atención médica
Judith Graham
Un nuevo estudio revela que los pacientes de Medicare dedican aproximadamente tres semanas al año a hacerse pruebas médicas, ver a doctores, someterse a tratamientos o procedimientos médicos, o pasar tiempo en el hospital o en centros de rehabilitación.
Sitios de telesalud prometen una cura para la “menopausia masculina” a pesar de prohibiciones
Michael Scaturro
En anuncios de Google, Facebook y otros medios, los sitios web de telemedicina sobre testosterona pueden prometer una solución rápida para la “lentitud” y la libido baja en los hombres. Pero los médicos dicen que no hay pruebas de su eficacia.