Watch: Older Americans Say They Feel Stuck in Medicare Advantage Plans
By Sarah Jane Tribble
January 22, 2024
KFF Health News Original
You’ve probably seen advertising about Medicare Advantage plans. KFF Health News’ Sarah Jane Tribble explains the pros and cons of this insurance option as enrollment in these plans increases.
After Public Push, CMS Curbs Health Insurance Agents’ Access to Consumer SSNs
By Julie Appleby
April 9, 2024
KFF Health News Original
Days after publication of a KFF Health News article about Obamacare enrollees being switched to different plans without their knowledge or consent, the Centers for Medicare & Medicaid Services took steps to tighten insurance agents’ access to private consumer information on the federal marketplace.
Unauthorized Sign-Ups Cast Shadow on Obamacare’s Record Enrollment
By Julie Appleby
April 4, 2024
KFF Health News Original
The Biden administration faces what looks like a growing problem for the federal Affordable Care Act’s insurance exchange: disreputable insurance brokers enrolling people who don’t need coverage or switching them to new plans without their authorization. It happened to Michael Debriae, a restaurant server who lives in Charlotte. Unbeknownst to him, an agent in Florida […]
Readers Weigh Downsides of Medicare Advantage and Stick Up for Mary Lou Retton
January 29, 2024
KFF Health News Original
KFF Health News gives readers a chance to comment on a recent batch of stories.
Whatever Happened to Biden’s Public Option?
By Elisabeth Rosenthal
April 26, 2024
KFF Health News Original
In the 2020 elections, then-candidate Joe Biden and many of his congressional colleagues loudly advocated for a federal “public option” health insurance plan. It was framed, at the time, as part of his incoming administration’s response to the pandemic. “Low-income Americans will be automatically enrolled in the public option at zero cost to them, though […]
Biden Cracks Down on Prior Authorization — But There Are Limits
By Lauren Sausser
January 18, 2024
KFF Health News Original
More than a year after it was initially proposed, the Biden administration announced a final rule yesterday that will change how insurers in federal programs such as Medicare Advantage use prior authorization — a long-standing system that prevents many patients from accessing doctor-recommended care. “When a doctor says a patient needs a procedure, it is […]
Biden’s Election-Year Play to Further Expand Obamacare
By Julie Rovner
April 25, 2024
KFF Health News Original
The Biden administration wants to make it easier for Americans to get dental care. But don’t try booking an appointment just yet. A new regulation out this month allows states to include adult dental care as a benefit that health insurers must cover under the Affordable Care Act. Following record ACA enrollment this year, the proposal represents an […]
KFF Health News' 'What the Health?': The Long Road to Reining In Short-Term Plans
July 13, 2023
Podcast
President Biden made good on a campaign promise this week with a proposal that would limit short-term health insurance plans that boast low premiums but also few benefits. Meanwhile, the Supreme Court’s decision to outlaw affirmative action programs could set back efforts to diversify the nation’s medical workforce. Alice Miranda Ollstein of Politico, Amy Goldstein of the Washington Post, and Rachel Cohrs of Stat News join KFF Health News’ chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KFF Health News’ Bram Sable-Smith, who reported the latest KFF Health News-NPR “Bill of the Month” about how a hospital couldn’t track down a patient, but a debt collector could.
A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary?
By Molly Castle Work
March 25, 2024
KFF Health News Original
There are legal safeguards to protect patients from big bills like out-of-network air-ambulance rides. But insurers may not pay if they decide the ride wasn’t medically necessary.
A Battle Between Drugmakers and Insurers Hits Patients in the Wallet
By Julie Appleby
March 20, 2024
KFF Health News Original
There’s a long-running battle between insurers and drugmakers over financial assistance programs that purport to help patients afford expensive drugs. And lately, insurers have been losing ground as lawmakers, regulators and courts weigh in. The issue is whether coupons and other copay aid many patients get from drugmakers should count toward annual insurance deductibles and […]
States Get in on the Prior Authorization Crackdown
By Bram Sable-Smith
February 15, 2024
KFF Health News Original
Last month, my colleague Lauren Sausser told you about the Biden administration’s crackdown on insurance plans’ prior authorization policies, with new rules for certain health plans participating in federal programs such as Medicare Advantage or the Affordable Care Act marketplace. States are getting in on the action, too. Prior authorization, sometimes called pre-certification, requires patients […]
Will CMS Crack Down on Prior Authorization?
By Lauren Sausser
January 9, 2024
KFF Health News Original
There’s the Idaho doctor whose infant daughter developed a brain tumor. A woman in Southern California who waited months for an MRI before dying in the hospital. And a North Carolina patient who has trigeminal neuralgia — a condition so painful it’s commonly called the “suicide disease.” They all have something in common, aside from […]
Medicare Advantage Is Popular, but Some Beneficiaries Feel Buyer’s Remorse
By Sarah Jane Tribble
January 23, 2024
KFF Health News Original
Medicare Advantage plans are booming — 30.8 million of the 60 million Americans with Medicare are now enrolled in the private plans rather than the traditional government-run program. But a little-known fact: Once you’re in a Medicare Advantage plan, you may not be able to get out. Traditional Medicare usually requires beneficiaries to pay 20 […]
An Arm and a Leg: The Medicare Episode
By Dan Weissmann
March 11, 2024
Podcast
On this episode of “An Arm and a Leg,” host Dan Weissmann breaks down the complicated and expensive world of Medicare with practical tips to pick the right plan and avoid penalties.
Rising Complaints of Unauthorized Obamacare Plan-Switching and Sign-Ups Trigger Concern
By Julie Appleby
April 8, 2024
KFF Health News Original
Federal and state regulators are mulling what they can do to thwart this growing problem.
Uncle Sam Wants You … to Help Stop Insurers’ Bogus Medicare Advantage Sales Tactics
By Susan Jaffe
November 30, 2023
KFF Health News Original
The Biden administration wants to crack down on deceptive or misleading Medicare Advantage and drug plan sales tactics. It’s counting on beneficiaries to help catch offenders.
ACA Plans Are Being Switched Without Enrollees’ OK
By Julie Appleby
April 2, 2024
KFF Health News Original
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.
How Your In-Network Health Coverage Can Vanish Before You Know It
By Elisabeth Rosenthal
March 15, 2024
KFF Health News Original
One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of “qualifying life events.” But insurers’ contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.
Under Fire for Massive Health System Hack, Biden Team Leans on Insurers
By Darius Tahir
March 19, 2024
KFF Health News Original
The Biden administration has hit on a strategy to deal with the massive, industry-paralyzing cyberattack on a UnitedHealth Group unit: pressuring insurers to fix it. Federal officials have been in constant conversation with senior leaders at UnitedHealth and across the industry, including at a Monday meeting where Department of Health and Human Services and White […]
Sign Here? Financial Agreements May Leave Doctors in the Driver’s Seat
By Katheryn Houghton
April 30, 2024
KFF Health News Original
Agreeing to an out-of-network doctor’s own financial policy — which generally protects their ability to get paid and may be littered with confusing insurance and legal jargon — can create a binding contract that leaves a patient owing.