Medicaid Work Rule Leaves Homeless People in the Cold
Conservatives who have long pushed for Medicaid work requirements often said vulnerable people would get a pass. But the federal government’s list of exemptions left off homeless people.
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Kennedy, Oz Contend Fraud Crackdown, Not Skyrocketing Prices, Led Millions To Leave Obamacare
Rising premiums forced many people in Affordable Care Act plans to give up their coverage. But the Trump administration claims a huge drop in enrollment is almost entirely due to its fraud crackdown.
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Hospice’s Bad Reputation Amid Fraud Crisis Will Hurt Patients, Industry Experts Warn
While acknowledging that changes must be made to the hospice industry, health policy researchers and providers worry that negative attention and the potential for overly punitive regulations could put patients at risk.
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Doctors ‘Cringe’ at Possibility of Documenting Which Medicaid Enrollees Too Sick To Work
Final regulations on Medicaid work requirements say enrollees must regularly obtain documentation — possibly from medical professionals — to prove that they’re too sick to work. Doctors say the rules put them in a tough spot.
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Violence Repeatedly Erupts at Dementia Care Facilities Despite Warnings, Inspections Show
Nursing homes and assisted living facilities can be fertile ground for violence between residents with dementia, including fatal assaults. A KFF Health News examination of health reports and court records shows how warning signs are missed and safeguards fall short.
By Jordan Rau -
Insurers Hedge on Trump-Backed Pledge To Improve Denials Process
Last year, the Trump administration announced a voluntary pledge by dozens of insurers to improve prior authorization, which often requires patients to seek approval before treatments. But prior authorization remains commonplace, and there's no evidence the government is trying to hold insurers to account.
By Lauren Sausser and Renuka Rayasam -
Facing Funding Losses, States Call Out Big Businesses With Employees on Medicaid
With the federal Medicaid work requirements looming in January, Democrats are considering state legislation to call out big companies that employ workers enrolled in the safety net health program. Business giants such as Amazon and Walmart said the figures are misleading.
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As GOP Cries Fraud, Newsom Backs Medicaid Spending on Housing and Food
Republicans say California’s use of Medicaid money for social services amounts to waste, fraud, and abuse. But even as Gov. Gavin Newsom voices concern about losing funding, he says he’s proud of the state’s holistic approach to caring for its sickest and most expensive patients.
By Angela Hart -
They Harvest the Nation’s Food, but a New Rule May Strip Them of Health Insurance
New Medicaid work requirements could make a complex system even harder for farmworkers to navigate.
By Paula Andalo -
Thousands of Medicare Beneficiaries Thought Their Drug Plan Was Free. Then They Lost It.
Thousands of people who had a Medicare drug plan with zero-dollar premiums last year got small premium increases this year — and didn’t know it. They were dropped from their coverage for failing to pay amounts as little as $8, and most can’t get it again until 2027.
By Susan Jaffe -
Medicare Advantage Company Pays $342M to Government in Midst of Billing Probe
The payment by Elevance Health to the Centers for Medicare & Medicaid Services comes as the agency threatened to bar new enrollments in the company’s plans.
By Fred Schulte -
Backed by Threat of Clawbacks, Feds Wield Tight Grip on $50B Rural Health Fund
Mehmet Oz, head of the Centers for Medicare & Medicaid Services, framed the $50 billion Rural Health Transformation Program as “bold, creative plans” led by states. But as states have started to roll out their plans, federal officials control where and how the money is spent.
By Sarah Jane Tribble and Arielle Zionts -
Long-Awaited Rule Aims To Boost ACA Choices While Embracing Higher Deductibles
The Trump administration finalized a rule that embraces new types of Obamacare coverage, including 30% higher out-of-pocket costs for some plans, and a more novel approach that allows insurers to offer coverage without set networks of doctors and hospitals.
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Final Rules for Medicaid Work Requirements Are Out. Here’s What You Need To Know.
The Trump administration has laid out what millions of Americans on Medicaid must do to prove they’re working or completing other activities. Health policy researchers and consumer advocates say there are some important takeaways.
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Trump’s Medicaid Work Rules Force States To Scrap Plans and Rework Systems
Health experts and advocates for low-income people say federal rules implementing President Donald Trump’s new Medicaid work requirements upend months of work by state governments to prepare the computer systems that determine who’s eligible for benefits.
By Rachana Pradhan and Samantha Liss -
Trump Bought Stock in Drugmaker as His Government Boosted Its Obesity Drugs
New ethics disclosures show the president invested in Eli Lilly and a company that manufactures injectable devices as his health agencies implemented policies that benefited them.
By Darius Tahir -
A New Medicare Option for Weight Loss Drugs: What Older Americans Should Know
It may soon get easier for millions of people with Medicare to get discounted GLP-1 drugs for weight loss.
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HHS’ Healthy Food Agenda Puts Hospitals on Notice About Patients’ Meals
The backlash was immediate after the Trump administration served notice that hospitals and nursing homes should limit sugary drinks and dietary supplements in favor of what the Department of Health and Human Services terms “real food.”
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Big Companies Position Themselves for Payday From $50B Federal Rural Health Fund
A $50 billion federal fund is supposed to modernize rural health with electronic health records, AI, telehealth, and more. But community clinics and rural health advocates fear that the contractors administering the money for states will bite off a big chunk before it reaches rural patients.
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Florida Delays Children’s Health Insurance Expansion as Uninsured Rate Rises
Florida’s KidCare expansion has been stuck in legal limbo since February 2024. Since then, the number of uninsured children in Florida has risen to 400,000 — one of the highest state tallies.
By Daniel Chang