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Many states are trying to restrain Medicaid spending by putting more people into managed care plans, but with billions of dollars at stake, insurers and health providers are lobbying hard for their interests.
The groups are financed through a monthly fee, and those revenues are divvied up and sent to members when they have health care expenses.
The billing can get complicated if doctors find a polyp during a screening: Some insurers
In her search for a health plan, Lisa Drew discovered that her ZIP code was a black hole for individual coverage.
Live organ donors - who can offer kidneys or part of their liver, lung or pancreas
RAND Health Vice President and Director Arthur Kellermann, M.D., disputes the way his organization's research was depicted in a recent column by John Goodman about Medicaid. Kellerman notes the study in question was designed to examine health care quality, not to determine the value of different types of insurance.
The centers, designed to help low-income and uninsured people, offer an affordable option for care, but it can also be tough to get an appointment.
Pennsylvania has long been a laboratory for innovation in providing health coverage to the uninsured. But this legacy came crashing down earlier this year when 42,000 adultBasic enrollees lost their health insurance. The program's termination was explained as a "fiscal reality," but this fiscal decision is not a sound investment in the state's future.
Mark Bertolini knows the insurance industry inside out. Both he and his son have had life-threatening health crises. He says he wouldn't qualify for an individual policy and talks with KHN about how Aetna is reacting to the health law.
Much has been made of the health insurance exchanges in Utah and Massachusetts and whether they represent opposite points of a continuum of what exchanges can and should provide for consumers and small businesses. But is that really true or is the reality far more nuanced?
KHN's Mary Agnes Carey talks with CQ HealthBeat's Rebecca Adams about the fiscal 2012 budget plan from House Budget Committee Chairman Paul Ryan. It would dramatically change Medicaid and Medicare.
Recent lawsuits show the government is cracking down on suspected anti-competitive actions in the health care and insurance industries.
Are vouchers the same as premium support? Will seniors' health care look like that offered federal workers? A guide to some of the questions and issues in the House Budget chairman's plan.
A recent Rand study found that in families with high-deductible plans, kids were less likely to get immunizations and adults were less likely to get cancer screenings. Not only did this seem to jeopardize the beneficiares' health, it also called into question the cost savings.
Officials say they will revise the requirements to deal with objections raised by insurers.
Health insurance companies respond to new regulations by expanding into related
The Healthy Indiana Plan is the Hoosier state's alternative to traditional Medicaid. It's boosters also consider it a viable alternative to the dreaded Affordable Care Act. But do they really have a case?
Insurance agents fear the health reform law threatens their livelihood and want changes in rules to protect their commissions and guarantee them a role in the new health exchanges.
The recession and rising health costs create financial hardships or cause consumers to forgo care, according to a survey by the Commonwealth Fund.
A bill introduced by House Democrats would require members of Congress to declare whether they are taking health benefits subsidized by taxpayers. The bill has next to no chance of passing because Republicans control the House. But its introduction puts some heat on the GOP.
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