UnitedHealth Wins Ruling Over $2B in Alleged Medicare Advantage Overpayments
A special master found the Justice Department failed to prove wrongdoing by the giant health insurer.
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House GOP Plan Targets Medicaid
Episode 386The House passed a budget plan that likely would result in major cuts to the Medicaid program. But the plan now faces a battle in the Senate, where even Republicans seem reluctant to dramatically reduce a health program that covers roughly 1 in 5 Americans. Meanwhile, federal judges and the Trump administration continue to differ over whether the administration has the authority to unilaterally cancel programs approved and funded by Congress and to fire federal workers. Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Victoria Knight of Axios join KFF Health News chief Washington correspondent Julie Rovner to discuss these stories and more.
Medicaid in the Crosshairs, Maybe
Episode 385President Donald Trump has said he won’t support major cuts to the Medicaid health insurance program for people with low incomes, but he has endorsed a House budget plan that calls for major cuts, leaving the program’s future in doubt. Meanwhile, thousands of workers at the Department of Health and Human Services were fired over the holiday weekend, from the National Institutes of Health, the FDA, and the Centers for Disease Control and Prevention, with possibly more cuts to come.
Alice Miranda Ollstein of Politico, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Sarah Karlin-Smith of the Pink Sheet join KFF Health News’ Julie Rovner to discuss these stories and more.
Creating Chaos at HHS
Episode 381President Donald Trump was sworn in Monday and by Wednesday had virtually stopped scientific policymaking at the Department of Health and Human Services. While incoming administrations often pause public communications, the acting HHS head ordered an unprecedented shutdown of all outside meetings, travel, and publications. Meanwhile, Trump issued a broad array of mostly nonbinding executive orders, but notably none directly concerning abortion. Rachel Cohrs Zhang of Stat, Alice Miranda Ollstein of Politico, and Rachel Roubein of The Washington Post join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Rodney Whitlock, a former congressional staffer, who explains the convoluted “budget reconciliation” process Republicans hope to use to enact Trump’s agenda.
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Voters Backed Abortion Rights but State Judges Have Final Say
Though abortion rights supporters prevailed on ballot measures in seven of the 10 states where abortion was up for a vote on Nov. 5, the state supreme courts voters have elected indicate legal fights to come aren’t clear-cut.
New Year, New Congress, New Health Agenda
Episode 379Health is unlikely to be a top priority for the new GOP-led 119th Congress and President-elect Donald Trump. But it’s likely to play a key supporting role, with an abortion bill already scheduled for debate in the Senate. Meanwhile, it’s unclear when and how the new Congress will deal with the bipartisan bills jettisoned from the previous Congress’ year-end omnibus measure — including a major deal to rein in the power of pharmacy benefit managers. In this “catch up on all the news you missed” episode, Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Lauren Weber of The Washington Post join KFF Health News’ Julie Rovner to discuss these stories and more.
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In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M
A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.
By Fred Schulte -
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Obamacare Sign-Ups Lag After Trump Election, Legal Challenges
The number of new and returning enrollees using healthcare.gov — the federal marketplace that serves 31 states — is well below last year’s as of early December. Also, a Biden administration push to give “Dreamers” access to Obamacare coverage and subsidies is facing court challenges.
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A Killing Touches Off Backlash Against Health Insurers
Episode 376The shocking shooting death of UnitedHealthcare’s chief executive in Midtown Manhattan prompted a public outcry about the problems with the nation’s health care system, as stories of delayed and denied care filled social media. Meanwhile, President-elect Donald Trump continues to avoid providing specifics about his plans for the Affordable Care Act and other health issues. Alice Miranda Ollstein of Politico, Sandhya Raman of CQ Roll Call, and Rachel Cohrs Zhang of Stat join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Francis Collins, who was the director of the National Institutes of Health and a science adviser to President Joe Biden.
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Federal Judge Halts Dreamers’ Brand-New Access to ACA Enrollment in 19 States
A federal judge sided with 19 states seeking an injunction against a Biden administration rule allowing recipients of Deferred Action for Childhood Arrivals to enroll in Affordable Care Act coverage and qualify for subsidies amid the annual open enrollment period.
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Six Years Into an Appalachia Hospital Monopoly, Patients Are Fearful and Furious
Ballad Health, with the largest state-sanctioned hospital monopoly in the nation, has failed for years to meet many quality-of-care goals, leaving some patients afraid of their local hospitals but with no other nearby options.
By Brett Kelman A Colorful Cast Could Lead Key Health Agencies
Episode 375President-elect Donald Trump has made his choices to fill some top jobs at the Department of Health and Human Services. They include controversial figures who were vocal critics of the Biden administration’s handling of the covid pandemic and have proposed sweeping changes to the agencies they would lead. Meanwhile, the Supreme Court heard its first two health-related cases of the term, challenging a Tennessee law barring transgender medical care for minors and, separately, challenging the FDA’s handling of e-cigarettes. Joanne Kenen of the Johns Hopkins University and Politico, Shefali Luthra of The 19th, and Sarah Karlin-Smith of the Pink Sheet join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF Health News’ Bram Sable-Smith, who reported and wrote the latest KFF Health News-Washington Post Well+Being “Bill of the Month” feature, about an emergency room bill for a visit that didn’t get past the waiting room.
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California Falling Short of Enrollment Goal as Mental Health Courts Roll Out Statewide
California’s goal was to help 2,000 seriously mentally ill people by the end of this year, but data shows fewer than 600 petitions have been filed. As the CARE program expands to every county, officials say it sometimes takes months to locate eligible adults and get them in treatment plans.
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Trump Doesn’t Need Congress To Make Abortion Effectively Unavailable
President-elect Donald Trump vowed on the campaign trail not to sign a nationwide abortion ban. But he wouldn’t need to do so to make abortion difficult, or illegal, writes KFF Health News’ chief Washington correspondent, Julie Rovner.
By Julie Rovner -
Immigration Detention Center Contractor Sues Over California Health Inspections
A private immigration detention center contractor has sued to block a California law allowing local public health officials to inspect facilities in response to allegations of medical neglect or unsanitary conditions.
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Georgians With Disabilities Are Still Being Institutionalized, Despite Federal Oversight
For nearly 15 years, the feds have had oversight of Georgia’s treatment of people with mental illness and developmental disabilities. Observers say the state still jeopardizes some of its most marginalized residents by not meeting the terms of its settlement with the Justice Department.
Trump’s Nontraditional Health Picks
Episode 373Not only has President-elect Donald Trump chosen prominent vaccine skeptic Robert F. Kennedy Jr. to lead the Department of Health and Human Services, Trump also has said he will nominate controversial TV host Mehmet Oz to run the Centers for Medicare & Medicaid Services, which oversees coverage for nearly half of Americans. Meanwhile, the lame-duck Congress is back in Washington with just a few weeks to figure out how to wrap up work for the year. Rachel Cohrs Zhang of Stat, Sandhya Raman of CQ Roll Call, and Riley Ray Griffin of Bloomberg News join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Sarah Varney, who has been covering a trial in Idaho challenging the lack of medical exceptions in that state’s abortion ban.
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Idaho Calls Abortion ‘Barbaric and Gruesome’ in Trial Challenging Strict Ban
Women with serious pregnancy complications who were denied abortion care have turned to state courts after appeals to state lawmakers to clarify medical exceptions have largely failed.
By Sarah Varney