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The Centers for Medicare & Medicaid Services is hunting for Medicaid waste, fraud, and abuse in at least six Democratic-led states that expanded coverage to low-income and disabled immigrants without legal status, according to records obtained by KFF Health News and The Associated Press.
Michigan’s former top health official spent a year and $30 million building a system to implement work requirements for Medicaid recipients. The difficulties he encountered have him worried about 40 states and Washington, D.C., having to launch such systems by 2027.
Many people don’t know they can fight a health insurance denial, let alone how to do it. Here are practical tips for consumers who want to appeal a prior authorization decision.
Conventional wisdom says GLP-1 drugs must be taken indefinitely to maintain weight loss. But a growing number of researchers, payers, and providers are challenging that consensus and exploring whether — and how — to taper patients off expensive GLP-1 drugs.
About 90,000 people spent months in limbo as central Missouri’s major, and often only, provider fought over insurance contracts. Patients getting caught in the crossfire of disputes has become a familiar complication, as about 8% of hospitals have left an insurer network since 2021. Trump administration policies could accelerate the trend.
As states prepare to implement changes to Medicaid required by President Donald Trump’s recent tax-and-spending law, tribal leaders say they are concerned Native American enrollees could lose their coverage, despite exemptions made by Congress.
The cost of health insurance is rising faster than the price of eggs or gasoline.
This summer marks the 60th anniversary of Medicare and Medicaid, the twin government programs that have shaped the health care system into what it is today. In this special episode, KFF Health News’ Julie Rovner interviews two experts on the history, significance, and future of these programs: Medicare historian and University of North Carolina professor Jonathan Oberlander and George Washington University professor emerita Sara Rosenbaum, who has studied Medicaid since nearly its beginning and has helped shape Medicaid policy over the past four decades.
A joint project of NPR and KFF Health News, Healthcare Helpline helps you navigate the health system hurdles between you and good care. Send us your tricky questions, and we may tap a policy sleuth to puzzle them out. Here is what to do if your preventive care gets denied.
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Insurers will take drug costs, frequency of use, and other factors into account as they set premium amounts for the 2026 plan year.
The state is using an old source of funding to pay for a new money crunch: assisting out-of-state patients with the costs associated with abortion.
In rural Colorado and across rural America, Medicaid is a lifeline, especially for people who wouldn’t otherwise have easy access to health care. That includes low-income seniors who need supplemental coverage in addition to Medicare, and people of all ages with disabilities.
A couple in New York thought they bought insurance. Instead, they got fake “jobs.”
Consumers contemplating an early retirement or starting a business should calculate how Trump administration and congressional policy changes could increase their health insurance costs — and plan accordingly.
It’s a difficult rite of passage for young adults without job-based insurance. Here are some tips for getting started.
Young adults without jobs that provide insurance find their options are limited and expensive. The problem is about to get worse.
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GOP lawmakers in 10 states have refused for a decade to expand Medicaid under the Affordable Care Act. But when President Donald Trump got another whack at Obamacare, these holdout states went unrewarded.
More than a dozen states are seeking their own versions of Medicaid work requirements. But the incoming federal standards pose questions around how much leeway states have to design their rules.
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