Insurers Running Medicare Advantage Plans Overbill Taxpayers By Billions As Feds Struggle To Stop It
An enhanced government effort to catch insurers that overcharge Medicare faces resistance from the insurance industry.
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Did Your Health Plan Deny You Care? Fight Back.
Most patients don’t argue when their health insurance won’t cover treatment or medication, but they should: Consumers win about half of their appeals. The process can sometimes be overwhelming, but there are ways to prepare and get help.
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Even When HIV Prevention Drug Is Covered, Other Costs Block Treatment
The U.S. Preventive Services Task Force recommended that people who are at high risk of contracting HIV take PrEP, a preventive treatment. The decision means most health plans will be required to cover the drugs without charging patients. But the recommendation doesn’t apply to the other clinical and lab services people need.
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Must-Reads Of The Week From Brianna Labuskes
Newsletter editor Brianna Labuskes wades through hundreds of health care policy stories each week, so you don't have to.
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Despite Federal Protections, Rape Victims Still Get Billed For Forensic Exams
Under federal law, people who have been raped don’t have to pay for medical forensic exams, yet many get billed and have trouble getting the hospitals or collection agencies to stop dunning them for payment.
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Listen: Young Undocumented Californians Cheer Promise Of Health Benefits
California is the first in the nation to expand Medicaid to young adults living there without legal permission.
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DOJ Lawyers Try New Tricks To Undo Obamacare. Will It Work?
KHN consulted legal experts about some of the arguments advanced by Trump administration lawyers during the most recent round of oral arguments in the legal challenge brought by 18 “red” states to overturn the Affordable Care Act.
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KHN’s ‘What The Health?’: Could The ACA Really Go Away?
Is the entire Affordable Care Act unconstitutional? That was the question before a federal appeals court in New Orleans this week. Two of the three judges on the panel seemed inclined to agree with a lower court that the elimination of the tax penalty for failure to maintain coverage could mean the entire health law should fall. Also this week, President Donald Trump wants to improve care for people with kidney disease. Joanne Kenen of Politico, Kimberly Leonard of the Washington Examiner and Alice Miranda Ollstein of Politico join KHN’s Julie Rovner to discuss this, plus courts blocking efforts to require drug prices in TV ads and to kick Planned Parenthood out of the federal family planning program. Plus, Rovner interviews University of Michigan law professor Nicholas Bagley about the latest legal threat to the ACA.
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Hospitals Block ‘Surprise Billing’ Measure In California
California lawmakers on Wednesday pulled legislation that would have protected some patients from surprise medical bills for emergency care, citing opposition from hospitals. They vowed to resurrect the bill next year.
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Biden Calling ACA A ‘Breakthrough’ For Mental Health Parity Only Highlights Gaps
Did the Affordable Care Act create equal coverage of mental and physical health? Seems true on paper but not always in practice.
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Using Obamacare Authority, Trump Aims To Shift Dialysis Care To Patients’ Homes
Only about 12% of dialysis patients get their treatment at home and the initiative aims to dramatically increase that number and move patients out of costly dialysis centers. It would also add provisions to boost the annual number of kidneys available for transplants.
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Medicare Going In ‘Right Direction’ On Opioid Epidemic
A new report by the inspector general for HHS shows prescriptions to treat opioid addiction are way up in recent years, while prescriptions for the painkillers have fallen.
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‘An Arm And A Leg’: The Full Story Of Insulin And Its Cost ― No Sugarcoating It
Skipping meals. Rationing medicine to make it last. The high cost of insulin has pushed some people with diabetes to make hard choices. Hear about insulin’s backstory and the hacks that might make it affordable.
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How To Get A Cheaper Prescription Before Leaving The Doctor’s Office
A pricing tool embedded in their electronic health record and prescribing system lets doctors see how much patients will pay out-of-pocket based on their insurance and the pharmacy. But doctors have been slow to adopt the technology, which has limitations.
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Watch: High Cost Of Insulin Sends Americans To Canada To Stock Up
KHN, in collaboration with PBS NewsHour, reports on the skyrocketing cost of insulin — and the trend's deadly consequences. The price in the U.S. nearly doubled from 2012 to 2016, prompting some patients and activists to travel to Canada, where insulin can be 90% cheaper.
By Sarah Varney -
With ACA’s Future In Peril, California Reins In Rising Health Insurance Premiums
Premiums will grow by an average of 0.8% next year on the state health insurance exchange. Officials cite two new policies for the relatively low rate hike: a new state tax penalty on Californians who don’t have health insurance coupled with state-based tax credits to help enrollees afford their premiums, including middle-income people who make too much money to qualify for federal financial aid.
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Listen: Black Pharmacists Are Helping Close A Cultural Health Care Divide
KHN Midwest correspondent Cara Anthony is interviewed on Illinois Public Media’s “The 21st” by Niala Boodhoo about how black pharmacists are helping fill a void for African American patients seeking culturally competent care.
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Picture Of Health
Medi-Cal Enrollment Among Immigrant Kids Stalls, Then Falls. Is Fear To Blame?
Enrollment among undocumented immigrant children in California’s Medicaid program started strong before stagnating and then falling. Although this decline is similar to an enrollment decline among all children in Medicaid nationwide, experts believe there are different reasons behind it.
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Federal Appeals Court Takes Up Case That Could Upend U.S. Health System
The Affordable Care Act is again being put to the test after a lower court judge ruled the massive health law unconstitutional. Could the case ricochet back to the Supreme Court in the throes of the 2020 presidential campaign season?
By Julie Rovner -
Sobering Up: In An Alcohol-Soaked Nation, More Seek Booze-Free Social Spaces
A national trend of boozeless bars is cropping up nationwide to create social spaces without the hangovers, DUIs and alcoholism culture. It’s part of a new push for sober options.