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KHN’s ‘What the Health?’: Finally Fixing the ‘Family Glitch’

October 13, 2022 KFF Health News Original

The Biden administration has decided to try to fix the so-called “family glitch” in the Affordable Care Act without an act of Congress. The provision has prevented workers’ families from getting subsidized coverage if an employer offer is unaffordable. Meanwhile, Medicare’s open enrollment period begins Oct. 15, and private Medicare Advantage plans are poised to cover more than half of Medicare’s 65 million enrollees. Margot Sanger-Katz of The New York Times, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these topics and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read.

Trump Administration Bumps Payment Rates For Medicare Insurers By 5%

April 8, 2025 Morning Briefing

The boost is double the one proposed in January by the Biden administration. Meanwhile, a study shows how UnitedHealth Group used certain strategies to get more money from Medicare Advantage.

Even Negotiated Medicare Prices Of 10 Drugs Higher Than In Peer Nations

December 3, 2024 Morning Briefing

Researchers analyze the prices on drugs negotiated by Medicare, in comparison to what they cost in other countries. Other Medicare news relates to Medicare Advantage ratings, open enrollment, and veterans.

Morning Briefing for Monday, September 30, 2024

September 30, 2024 Morning Briefing

Medicare Advantage, drug use, bird flu, health impact of big storm, IVF coverage, maternal health, and more are in the news.

Morning Briefing for Wednesday, October 16, 2024

October 16, 2024 Morning Briefing

Medical debt, birth control, IV fluid shortage, abortion law, long covid, Medicare Advantage plans, pharmacies closing, and more

New Alzheimer’s Drug Raises Hopes — Along With Questions

By Judith Graham August 11, 2023 KFF Health News Original

Clinics serving Alzheimer’s patients are working out the details of who will get treated with the new drug Leqembi. It won’t be for everyone with memory-loss symptoms.

Regional Nonprofit Insurers See Largest Dip In Operating Margins

September 26, 2025 Morning Briefing

Smaller insurers were also found more susceptible to Medicaid cuts, a report found. Meanwhile, 29 states see at least a 20% increase in insurance rates from the top insurers. Also in the news: Medicare drug prices, Medicare Advantage, and more.

Medicare To Test Prior Authorizations In 6 States As Part Of A Pilot Program

September 2, 2025 Morning Briefing

The program will use AI to review cases, which some experts say could lead to inappropriate denials of care. Also in the news: more on prior authorization, Medicare Advantage, the impact of Medicaid cuts on maternity care, aging alone, and more.

Insurers Bilked $50B From Medicare For Dubious Diagnoses, Review Finds

July 8, 2024 Morning Briefing

In its analysis of the Medicare Advantage program, The Wall Street Journal looked at details of “doctor visits, hospital stays, prescriptions and other care.” Separately, a Stat review has found that more than two dozen Medicare Advantage insurers now qualify for big taxpayer-funded bonuses.

GOP Can’t Attain Budget Goal Without Cuts To Medicaid, Medicare, Or CHIP

March 6, 2025 Morning Briefing

The nonpartisan Congressional Budget Office released an analysis Wednesday. Other coverage from Capitol Hill and the White House is on high-deductible health plans, price transparency, Medicare Advantage lawsuits, and more.

Moody’s Dings Health Insurance Sector With ‘Negative’ Outlook

February 5, 2025 Morning Briefing

The ratings agency expects Medicare Advantage, Medicaid, and commercial insurers to continue to see high medical costs this year. More industry news is about Baystate Health, Tricare East, and others.

Megabill Scraps ‘Silver Loading,’ Potentially Disrupting ACA Plans

June 12, 2025 Morning Briefing

Although the measure would reduce Silver plan premiums, an estimated 300,000 people would lose health coverage, experts say. Meanwhile, Senate Republicans won’t be targeting Medicare Advantage changes after all.

2 Patient-Assistance Charity Groups Merge To Form $800M Foundation

March 4, 2026 Morning Briefing

The merger of the Patient Advocate Foundation and the Patient Access Network Foundation will allow them to better serve low- and middle-income patients facing rising health care costs, leaders say. Also: Insurers react to CMS’ proposed 2027 Medicare Advantage rates.

Listen to the Latest ‘KFF Health News Minute’

January 2, 2024 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.

OIG Reports Reveal 3 Health Insurers’ Medicare Advantage Overcharges

September 27, 2024 Morning Briefing

Humana, HealthAssurance Pennsylvania, and EmblemHealth are accused of overcharging taxpayers to the tune of $140 million by exaggerating the severity of Medicare Advantage members’ illnesses.

New Weight Loss Drugs Carry High Price Tags and Lots of Questions for Seniors

By Judith Graham July 25, 2023 KFF Health News Original

Although nearly 40% of Americans 60 and older are obese, Medicare doesn’t cover weight loss medications. Meanwhile, studies haven’t thoroughly examined new drugs’ impact on older adults.

Morning Briefing for Tuesday, August 27, 2024

August 27, 2024 Morning Briefing

Open enrollment, opioid settlement funds, Medicare Advantage overbilling, weight loss drugs, extreme heat, mosquito-borne diseases, and more

Former Medicare Chief Warns About Medicare Advantage Pay Rates

October 18, 2024 Morning Briefing

Donald Berwick, who ran Medicare during the Obama administration, says Medicare Advantage plans run by private insurers need a lot more regulation. He suggests a two-pronged system fix that would take the overpayments out of MA and use that money to cover vision, dental, and hearing service in traditional Medicare, Stat says.

Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients

By Lauren Sausser March 13, 2023 KFF Health News Original

The federal government wants to change the way health insurers use prior authorization — the requirement that patients get permission before undergoing treatment. Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization has become a confusing maze that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New rules may not be enough to solve the problems.

Doctors and Patients Try to Shame Insurers Online to Reverse Prior Authorization Denials

By Lauren Sausser August 23, 2023 KFF Health News Original

Prior authorization is a common tool used by health insurers for many tests, procedures, and prescriptions. Frustrated by the process, patients and doctors have turned to social media to publicly shame insurance companies and elevate their denials for further review.

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