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These fixers, officially known as caseworkers, unraveled complex and arcane health insurance rules to solve people’s coverage issues. They worked in a little-known federal department with which most consumers never interact — until they need help.
Although knee replacements are usually covered by health insurance, amputees face roadblocks to coverage and often must prove their prosthetics are medically necessary.
A stressed primary care system has led many doctors to start practices that charge membership fees in exchange for shorter waits and longer appointments. Observers say the doctor shortage needs a more systemic fix.
Republicans are pushing to implement requirements that Medicaid recipients work in order to obtain or retain coverage. Some states try to help enrollees find jobs. But states lack the data to show whether they’re effective.
KFF Health News journalists made the rounds on national and local media recently to discuss topical stories. Here’s a collection of their appearances.
Recent cuts eliminated a small, specialized workforce that sets the poverty standards determining who is eligible for Medicaid as well as assistance with food, home heating, child care, and more.
Consumers who were enrolled fraudulently in Affordable Care Act coverage could receive unexpected tax bills — the first and possibly only clue they were a victim of fraud. Getting help may become difficult as federal workers are laid off and funding for assistance programs is cut.
Some rural hospitals have canceled — or are considering ending — contracts with insurance companies that offer Medicare Advantage plans, saying the private policies jeopardize their finances and impede patient care.
Undue Medical Debt is retiring unpaid medical bills for 20 million people. The debt trading company that owned them is leaving the market.
The GOP-controlled Congress is weighing cuts to Medicaid, the government health program that covers millions of Americans — including nearly 40% of Louisianans represented in the House by Speaker Mike Johnson.
Families, nursing facilities, and home health agencies rely on foreign-born workers to fill health care jobs that are demanding and do not attract enough American citizens. The Trump administration’s anti-immigration policies threaten to cut a key source of labor for the industry, which was already predicting a surge in demand.
As House Republicans mull a massive $880 billion cut from federal programs likely including Medicaid, constituents, disability advocates, and health care providers are joining forces to lobby GOP members in California — including those who represent rural, deeply conservative pockets that stand to lose the most.
Health care price transparency is one of the few bipartisan issues in Washington, D.C. But much of the information that hospitals and health plans have made available to the public is not helpful to patients, and there’s no conclusive evidence yet that it’s lowering costs or increasing competition.
A bill designed to force PBMs to pay higher fees to independent drugstores sailed through the state House, but lobbyists are marshaling their forces to kill the measure in the Senate.
Health plans limit physical or occupational therapy sessions to as few as 20 a year, no matter the patient’s infirmities. The limits persist despite federal rules banning insurers from setting annual dollar limits on the care they will provide.
After leaving his job to launch his own business, an Illinois man opted for a six-month health insurance plan. When he needed a colonoscopy, he thought it would cover most of the bill. Then he learned his plan’s limited benefits would cost him plenty.
The anti-fluoride movement has more momentum than ever. In rural counties with few dentists, tooth decay could surge to levels that have not been seen in decades, experts warn.
U.S. Rep. Nick LaLota, a Long Island Republican, told his constituents that he voted for the House-passed GOP budget resolution because it protects Medicaid, Medicare, and Social Security. However, the bill charges a committee with making cuts that likely can’t be attained without slashing Medicaid.
As politicians demand that more Medicaid recipients work, many people with disabilities say their state programs’ income and asset caps force them to limit their work hours or turn down promotions.
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