Their Physical Therapy Coverage Ran Out Before They Could Walk Again
By Jordan Rau
March 28, 2025
KFF Health News Original
Health plans limit physical or occupational therapy sessions to as few as 20 a year, no matter the patient’s infirmities. The limits persist despite federal rules banning insurers from setting annual dollar limits on the care they will provide.
Wyden Demands Penalties for Obamacare Enrollment Fraud
By Julie Rovner
May 30, 2024
KFF Health News Original
Lawmakers and state officials are turning up the heat on federal regulators to stop unscrupulous, commission-hungry insurance agents from enrolling thousands of people in Affordable Care Act plans, or switching their coverage, without their knowledge. Customers often don’t discover the changes until they’re denied medical coverage or get stuck with a bill for ACA tax […]
Biden Administration Tightens Broker Access to Healthcare.gov To Thwart Rogue Sign-Ups
By Julie Appleby
July 19, 2024
KFF Health News Original
The Centers for Medicare & Medicaid Services said it has received more than 200,000 complaints in the first six months of the year about people being signed up for Obamacare plans or switched to new plans without their consent.
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 […]
Nearly All Vermonters Have Health Insurance, but Care Is Tough To Find
November 20, 2024
KFF Health News Original
Almost all people have health insurance in Vermont, a state famed for its maple syrup and Ben & Jerry’s ice cream, yet residents pay the nation’s highest insurance premiums for individual coverage and endure months-long waits for care — and most hospitals here are losing money, according to state reports and interviews with residents and […]
Trump Threat to Immigrant Health Care Tempered by Economic Hopes
By Vanessa G. Sánchez
December 17, 2024
KFF Health News Original
Donald Trump’s second term is reigniting mistrust in health services among California immigrants, making it harder for community health workers to get people enrolled in Medi-Cal. Yet the president-elect is also seen as someone who could improve their lives with a better economy, even if that means forgoing health care.
Years Later, Centene Settlements With States Still Unfinished
By Andy Miller
March 5, 2025
KFF Health News Original
At least 20 states have settled disputes with health insurance giant Centene since 2021 over allegations that its pharmacy benefit manager operation overcharged their Medicaid programs. Two holdouts appear to remain: Georgia has not yet settled, and Florida officials won’t answer questions about its Centene situation.
Journalists Talk Shooting’s Toll on Children and State Handling of Opioid Settlement Funds
August 24, 2024
KFF Health News Original
KFF Health News and California Healthline staff made the rounds on national and local media in the last two weeks to discuss topical stories. Here’s a collection of their appearances.
Efforts To Curb ACA Enrollment Fraud Face Real-World Test
By Julie Appleby
November 26, 2024
KFF Health News Original
The current Affordable Care Act open enrollment season is the first big test of new federal guardrails against fraud. The rules aim to head off unauthorized ACA plan enrollments or switches by rogue agents and entities looking to make money via enrollment commissions. Such sign-ups triggered more than 274,000 consumer complaints through August this year. […]
‘They Won’t Help Me’: Sickest Patients Face Insurance Denials Despite Policy Fixes
By Lauren Sausser
March 31, 2025
KFF Health News Original
The fatal shooting of UnitedHealthcare CEO Brian Thompson prompted both grief and public outrage about the ways insurers deny treatment. Republicans and Democrats agree prior authorization needs fixing, but patients are growing impatient.
Misleading Ads Play Key Role in Schemes to Gin Up Unauthorized ACA Sign-Ups, Lawsuit Alleges
By Julie Appleby
Updated July 22, 2024
Originally Published July 19, 2024
KFF Health News Original
Misleading money-for-groceries ads helped lure people to call centers where some were enrolled in Affordable Care Act coverage — or switched from their existing plans — without their express permission, a new lawsuit alleges.
When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get To Leave, Too
By Susan Jaffe
April 28, 2025
KFF Health News Original
Breakups between health providers and Advantage plans are increasingly common. The Centers for Medicare & Medicaid Services has allowed whole groups of patients to leave their plans.
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.
Listen to the Latest ‘KFF Health News Minute’
January 7, 2025
KFF Health News Original
“Health Minute” brings original health care and health policy reporting from the KFF Health News newsroom to the airwaves each week.
KFF Health News' 'What the Health?': The Health of the Campaign
October 4, 2024
Podcast
The 2024 presidential race is taking on a familiar tone — with Democrats accusing Republicans of wanting to ban abortion and repeal the Affordable Care Act and Republicans insisting they have no such plans. Voters will determine whom they believe. Meanwhile, for the second time in a month, a state judge overturned an abortion ban, but few expect the decision to settle the matter. Alice Miranda Ollstein of Politico, Sandhya Raman of CQ Roll Call, and Anna Edney of Bloomberg News join KFF Health News chief Washington correspondent Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF Health News’ Lauren Sausser, who reported and wrote the latest KFF Health News-Washington Post “Bill of the Month,” about a teenage athlete whose needed surgery lacked a billing code.
Can House Republicans Cut $880 Billion Without Slashing Medicaid? It’s Likely Impossible.
By Madison Czopek, PolitiFact Amy Sherman, PolitiFact
March 13, 2025
KFF Health News Original
A Republican House resolution, which needs the Senate’s buy-in, directed a committee to propose ways to reduce the deficit by at least $880 billion over a decade. Lawmakers have taken Medicare off the table for cuts, which makes it impossible to reach $880 billion without cutting Medicaid.
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.
Thought Inflation Was Bad? Health Insurance Premiums Are Rising Even Faster
By Phillip Reese
March 11, 2025
KFF Health News Original
California businesses saw employees’ monthly family insurance premiums rise nearly $1,000 over a 15-year period, more than double the pace of inflation. And employees’ share grew as companies shifted more of the cost to workers.
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 […]
TV’s Dr. Oz Invested in Businesses Regulated by Agency Trump Wants Him To Lead
By Darius Tahir
November 21, 2024
KFF Health News Original
Celebrity doctor Mehmet Oz recently held broad investments in health care, tech, and food companies. Were he confirmed to run the Centers for Medicare & Medicaid Services, his job would involve interacting with giants of the industry that have contributed to his wealth.
