Analysis: Don’t Want a Vaccine? Be Prepared to Pay More for Insurance.
Health insurers could do more to encourage vaccination, including letting the unvaccinated foot their bills.
Insurers
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Diabetes Drug’s New Weight Loss Formula Fuels Cost-Benefit Debate
Health plans’ coverage of the medication, branded as Wegovy — which has a $1,300-a-month price tag — is not a sure thing.
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Contraception Is Free to Women, Except When It’s Not
The landmark federal health law required most commercial health plans to cover a comprehensive list of birth control methods approved by the Food and Drug Administration free of charge to female patients. But health plans don’t have to cover every option, and newer methods are not included in the federal list of covered services.
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Pandemic Swells Medicaid Enrollment to 80 Million People, a ‘High-Water Mark’
More than 80 million Americans with low incomes were receiving health coverage through the federal-state program in January. The program now covers nearly 1 in 4 people nationwide.
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Mental Health Services Wane as Insurers Appear to Skirt Parity Rules During Pandemic
A report from the Government Accountability Office paints a picture of an already strained behavioral health system struggling after the pandemic struck to meet the treatment needs of millions of Americans with conditions like alcohol use disorder and post-traumatic stress disorder.
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After Accident, Patient Crashes Into $700,000 Bill for Spine Surgery
Generous personal injury coverage on your car policy may not be enough to cover medical bills. Patients can get financially blindsided when auto insurance and health insurance policies differ.
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How Much of Trump’s Health Agenda Has Biden Undone?
In his campaign, President Joe Biden promised to undo policies, particularly health policies, implemented by former President Donald Trump. Yet, despite immense executive power, reversing four years of action takes time and resources.
By Julie Rovner -
‘Painless’ Glucose Monitors Pushed Despite Little Evidence They Help Most Diabetes Patients
The numbers of people wearing these monitors are soaring as prices have fallen and device-makers promote them to doctors and patients. But few studies show the devices lead to better outcomes for the nearly 25 million Americans with Type 2 diabetes who don’t inject insulin to regulate their blood sugar.
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Head-Scratching Over Newsom’s Choice of Blue Shield to Lead Vaccination Push
Gov. Gavin Newsom’s surprising choice of Blue Shield to lead the state’s covid vaccination effort raised questions about the role politics played in the decision — and whether the insurer is up to the task.
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Surprise Federal Drug Rule Directs Insurers to Reveal What They Pay for Prescription Drugs
A provision the Trump administration tucked into its final rule on health plan price transparency requires telling consumers what they will pay out-of-pocket for drugs and showing them what the plan paid.
By Harris Meyer -
Heartbreaking Bills, Lawsuit and Bankruptcy — Even With Insurance
With health insurance that can leave him on the hook for more than a quarter of his salary every year, a Kentucky essential worker who has heart disease is one of millions of Americans who are functionally uninsured. At only 31, he has already been through bankruptcy and being sued by his hospital. This year, he faced a bill for more than $10,000.
By Laura Ungar -
COVID + Influenza: This Is a Good Year to Get a Flu Shot, Experts Advise
A robust sign-up for flu shots could help head off a nightmare scenario in the coming winter of hospitals stuffed with both COVID-19 patients and those suffering from severe effects of influenza. Plus, no one knows how flu and COVID might interact if a patient got both.
By Julie Appleby and Michelle Andrews -
Don’t Count on Lower Premiums Despite Pandemic-Driven Boon for Insurers
Early in the pandemic, insurers expected the costs of treating COVID-19 would vastly increase medical spending. Instead, non-COVID care has plummeted and insurers have pocketed the result. Still, few industry observers are predicting broad-based premium cuts in 2021, though some health plans have proposed lowering their rates.
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For COVID Tests, the Question of Who Pays Comes Down to Interpretation
Additional guidance issued late last month by the Trump administration added to the confusion. Some consumers may find themselves unexpectedly on the hook for the cost of a test.
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Must-Reads of the Week
KHN's Midwest correspondent Lauren Weber drills through the vital health care policy stories of the week, so you don't have to.
By Lauren Weber -
Hospital Executive Charged In $1.4B Rural Hospital Billing Scheme
In an investigation last year, KHN detailed the rise and fall of Miami businessman Jorge A. Perez’s rural hospital empire, which spanned eight states and encompassed half of the rural hospital bankruptcies in 2019.
By Lauren Weber and Barbara Feder Ostrov -
Social Media Fears About Lack Of Coverage For Protest Injuries Are Overblown
After some protests over the death of George Floyd resulted in violence, online discussions raised concerns that health plans might deny medical coverage. Although plans do sometimes make exclusions for “illegal acts” or riots, experts say concerns by people who are protesting Floyd’s death may be overstated.
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Bill Of The Month
COVID-Like Cough Sent Him To ER — Where He Got A $3,278 Bill
A dad in Denver tried to do everything right when COVID symptoms surfaced. Still, he ended up with a huge bill from an insurer that had said it waived cost sharing for coronavirus treatment. What gives?
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Must-Reads Of The Week From Brianna Labuskes
Newsletter editor Brianna Labuskes wades through hundreds of health care policy stories each week, so you don't have to.
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KHN’s ‘What The Health?’: SCOTUS Decides An ACA Case. No, Not THAT Case.
The Supreme Court this week, in an 8-1 decision, ruled that insurers are due the roughly $12 billion that Congress several years ago tried to cut off in payments under the Affordable Care Act’s “risk corridors” provision. And while the COVID-19 pandemic continues to rage in many places around the country, states are starting to reopen their economies at the urging of President Donald Trump and over objections of public health officials. Caitlin Owens of Axios and Mary Ellen McIntire of CQ Roll Call join KHN’s Julie Rovner to discuss this and more. Also, Rovner interviews KHN’s Carmen Heredia Rodriguez, who wrote the latest KHN-NPR “Bill of the Month” installment about COVID testing that should have been free but was not.