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A Wisconsin retiree with glaucoma needed her eyes examined. Her Medicare Advantage plan from UnitedHealthcare listed her optometrist’s clinic as in-network, but she learned the hard way that a clinic can be in-network and out-of-network at the same time.
A federal probe of Medicare and Medicaid plans run by private insurance companies found that the plan operators often overstated how many mental health providers were available in their networks. In some cases, investigators found providers had never had contracts with plans they were listed on.
Millions of people rely on the supplemental insurance to offset the deductibles, copayments, and other costs faced by enrollees in the traditional Medicare program.
HHS Secretary Robert F. Kennedy Jr. had another tough week. In addition to Kennedy having rotator cuff surgery, the nomination of his ally to become surgeon general is teetering, the controversial head of the FDA's vaccine center is resigning next month, and a new survey shows Americans trust government health officials less than they do former Biden official Anthony Fauci. Anna Edney of Bloomberg News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Shefali Luthra of The 19th join KFF Health News’ Julie Rovner to discuss these stories and more.
Insurers will take drug costs, frequency of use, and other factors into account as they set premium amounts for the 2026 plan year.
Despite public opposition to the cuts they made to federal health programs in 2025, Republicans reportedly are considering more cuts to help pay for the war in Iran. Meanwhile, the Supreme Court ruled that Colorado cannot ban “conversion therapy” for LGBTQ+ minors. Jessie Hellmann of CQ Roll Call, Alice Miranda Ollstein of Politico, and Sandhya Raman of Bloomberg Law join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF Health News’ Elisabeth Rosenthal, who wrote the last two “Bill of the Month” stories.
Many people don’t know they can fight a health insurance denial, let alone how to do it. Here are practical tips for consumers who want to appeal a prior authorization decision.
Democrats and Republicans remain stalled over funding the federal government as Republicans launch a new attack on the Affordable Care Act. Meanwhile, the Trump administration is taking advantage of the shutdown to lay off workers from programs supported mostly by Democrats. Anna Edney of Bloomberg News, Lauren Weber of The Washington Post, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews health insurance analyst Louise Norris about Medicare open enrollment.
Democrats and conservatives are divided over whether the federal health program for people over 65 should be run almost entirely by the private sector. If Trump retakes the White House, the shift to Medicare Advantage may accelerate.
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.
The Trump administration’s immigration crackdown is not just roiling politics but also directly affecting the provision of health care, medical groups say. Meanwhile, in Washington, federal spending bills have been stalled by the fight over immigration enforcement funding after the shooting death of a second person in Minneapolis this month. Maya Goldman of Axios, Alice Miranda Ollstein of Politico, and Rachel Roubein of The Washington Post join KFF Health News’ Julie Rovner to discuss those stories and more.
Two Trump administration regulatory rollbacks affect nursing home staffing and home care workers, and a new AI experiment in Medicare has alarmed eldercare advocates and congressional Democrats.
Senate Democrats were promised a vote by mid-December on extending enhanced Affordable Care Act subsidies, but Republicans still can’t decide whether they want to put forward their own alternative or what that might include. Meanwhile, the CDC and FDA are roiled by debates over vaccines. Alice Miranda Ollstein of Politico, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Paige Winfield Cunningham of The Washington Post join KFF Health News’ Julie Rovner to discuss those stories and more. Also, Rovner interviews KFF Health News’ Aneri Pattani about her project tracking opioid settlement payments.
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.
KFF Health News gives readers a chance to comment on a recent batch of stories.
Experts disputed the claim by Republican vice presidential candidate JD Vance, noting that a range of other issues — from low reimbursement rates to declining patient use — combine to cause these facilities to shutter.
Dozens of health insurance companies pledged on Monday to improve prior authorization, a process often used to deny care. The announcement comes months after the killing of UnitedHealthcare executive Brian Thompson, whose death in December sparked widespread criticism about insurance denials.
When Congress returns next week, it will be writing a budget reconciliation bill that’s expected to cut taxes but also make deep cuts to Medicaid. But at least some Republicans are concerned about cutting a program that aids so many of their constituents. Sarah Karlin-Smith of the Pink Sheet, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico join KFF Health News’ Julie Rovner to discuss this story and more. Also, Rovner interviews KFF Health News’ Rae Ellen Bichell about her story on how care for transgender minors is changing in Colorado.
This week, the Trump administration won a court battle to delay a ruling on access to the abortion pill mifepristone, angering its own anti-abortion allies. Meanwhile, the president’s budget arrived on Capitol Hill, where lawmakers are unlikely to agree to its proposed cuts to Health and Human Services programs. Lauren Weber of The Washington Post, Alice Miranda Ollstein of Politico, and Maya Goldman of Axios join KFF Health News’ Julie Rovner to discuss these stories and more.
A small program celebrated by its proponents helps people modify their homes and safely live independently as they age. But most insurers won’t pay for it, including Medicare.
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