Latest Morning Briefing Stories
Who Gets Obesity Drugs Covered by Insurance? In North Carolina, It Helps If You’re on Medicaid
GLP-1 agonist medications such as Ozempic accounted for 10% of the North Carolina state employee health plan’s prescription drug spending, so the state is no longer covering them for weight loss alone. Still, it did decide to cover them for Medicaid patients’ weight loss. A look inside the state’s coverage calculus.
¿Podrían los nuevos medicamentos para bajar de peso estar disponibles para todos?
Los medicamentos agonistas GLP-1, conocidos por los nombres comerciales Ozempic, Trulicity y Wegovy, han demostrado ser efectivos para la pérdida de peso y para el manejo de la diabetes tipo 2.
A Toddler Got a Nasal Swab Test but Left Before Seeing a Doctor. The Bill Was $445.
A mom in Peoria, Illinois, took her 3-year-old to the ER one evening last December. While they were waiting to be seen, the toddler seemed better, so they left without seeing a doctor. Then the bill came.
Florida’s Deloitte-Run Computer System Cut Off New Moms Entitled to Medicaid
Florida discovered a glitch in its Deloitte-run Medicaid eligibility system. The problem, alleged in court testimony, led to new mothers wrongly losing their insurance coverage.
Indiana Hospitals Pull Merger Application After Pushback Over Monopoly Concerns
Two Indiana hospital rivals withdrew their application to merge after facing pushback from the Federal Trade Commission and the public.
Dicen que los esfuerzos contra el fraude en ACA han dado resultados. Pero hay que estar alerta
Los Centros de Servicios de Medicare y Medicaid atribuyen esta reducción a las medidas adoptadas para prevenir problemas de inscripción y cambios de planes, que ya habían generado más de 274,000 quejas hasta agosto.
Journalists Reflect on Trump Picks, Racism and Public Health, and Unnecessary Dental Implants
KFF Health News staff made the rounds on national and local media in the last two weeks to discuss topical stories. Here’s a collection of their appearances.
Florida Gov. DeSantis’ Canadian Drug Import Plan Goes Nowhere After FDA Approval
Florida sued the FDA over what it said was a “reckless delay” in approving its drug importation plan. Now, nearly a year after the FDA gave the state the green light, the program has yet to begin.
El plan del gobernador de Florida para importar medicamentos más baratos de Canadá sigue en la nada
Florida solicitó crear un programa de importación en noviembre de 2020, pocos meses después que la administración Trump concediera esta opción a los estados.
California Sets 15% Target for Primary Care Spending Over Next Decade
The state Office of Health Care Affordability has set a goal for insurers to direct 15% of their spending to primary care by 2034, part of a push to expand preventive care services. Health plans say it’s unclear how the policy will mesh with the state’s overarching goal to slow spending growth.
Washington Power Has Shifted. Here’s How the ACA May Shift, Too.
With a new Trump administration poised to move into the White House and Republicans set to control both chambers of Congress, party leaders are making a to-do list for the Affordable Care Act.
El poder en Washington ha cambiado. ACA podría cambiar también
El futuro gobernante prepara el terreno para hacer cambios potencialmente sísmicos que podrían limitar la expansión de Medicaid, aumentar la tasa de personas sin seguro, debilitar las protecciones para los pacientes y elevar los costos de las primas para millones de personas.
Nearly All Vermonters Have Health Insurance, but Care Is Tough To Find
Almost all people have health insurance in Vermont, a state famed for its maple syrup and Ben & Jerry’s ice cream, yet residents pay the nation’s highest insurance premiums for individual coverage and endure months-long waits for care — and most hospitals here are losing money, according to state reports and interviews with residents and […]
Listen: A Tussle With a Rattlesnake Can Take a Bite Out of Your Wallet
Listen to KFF Health News’ Jackie Fortiér recount how a backyard snakebite led to a harrowing hospitalization — and big bills — for a San Diego family.
FTC, Indiana Residents Pressure State To Block Hospital Merger
Hundreds of people and the Federal Trade Commission weighed in on a proposed hospital merger in Terre Haute, Indiana, with most arguing that the creation of a monopoly would increase costs and worsen patient care.
Social Security Tackles Overpayment ‘Injustices,’ but Problems Remain
With his term soon to expire, Social Security chief Martin O’Malley’s efforts to address the agency’s overpayments to beneficiaries remain incomplete.
Pay First, Deliver Later: Some Women Are Being Asked To Prepay for Their Baby
Pregnant women are being asked to make large cash payments months before they deliver their babies. Some patient advocates worry this billing practice allows providers to hold treatment hostage.
Es difícil saber con qué frecuencia ocurre porque se considera una transacción privada entre el proveedor y el paciente. Por lo tanto, los pagos no se registran en los datos de reclamos de seguros y, por ende, los expertos no los analizan.
An Arm and a Leg: Fight Health Insurance — With Help From AI
Meet the tech worker on a quest to use artificial intelligence to combat denials for coverage from patients’ health plans.
Many Voters Backed Abortion Rights and Donald Trump, a Challenge for Democrats
Despite widespread support for protecting abortion rights, voters said the cost of gas, housing, food, and health care was more important to their choice for president.
