Insurance

Latest KFF Health News Stories

Sticker Shock: Obamacare Customers Confront Premium Spikes as Congress Dithers

KFF Health News Original

With subsidies that give consumers extra help paying their health insurance premiums set to expire, lawmakers are again debating the Affordable Care Act. The difference this time: It’s happening in the middle of ACA open enrollment.

What the Health? From KFF Health News: Crunch Time for ACA Tax Credits

Podcast

Dec. 15 is the deadline to sign up for Affordable Care Act plans that begin Jan. 1, and Congress remains at odds over letting expanded tax credits for the plans’ premiums expire and increasing the cost of insurance for millions of Americans. Meanwhile, HHS Secretary Robert F. Kennedy Jr. continues to remake vaccine policy to reflect ideology rather than science. Anna Edney of Bloomberg News, Maya Goldman of Axios, and Sheryl Gay Stolberg of The New York Times join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews Georgetown professor Linda Blumberg about the GOP’s health plans.

Health Care Consolidation and Rising Costs Happen, but Obamacare Is Not the Key Culprit

KFF Health News Original

The debate over expiring Affordable Care Act tax credits has given Republicans room to resurface old criticisms — such as blaming the ACA for mergers and consolidation within the health care industry.

Plan-Switching, Sign-Up Impersonations: Obamacare Enrollment Fraud Persists

KFF Health News Original

Investigators from the Government Accountability Office were able to register nearly 20 fake ACA enrollments in a probe of healthcare.gov. The federal government paid subsidies to insurers for some of the fake customers.

Out-of-Pocket Pain From High-Deductible Plans Means Skimping on Care

KFF Health News Original

High-deductible health insurance plans are increasingly common, and many more enrollees will likely need to choose such plans for the coming year. For those with chronic conditions like diabetes, the gamble can mean compromised care and long-term consequences.

Watch: What Do Republicans Really Want on Health Care?

KFF Health News Original

On “What the Health? From KFF Health News,” distributed by WAMU, chief Washington correspondent and podcast host Julie Rovner sat down with Avik Roy, a GOP health policy adviser, to talk about how health care has evolved as a Republican Party issue.

They Need a Ventilator To Stay Alive. Getting One Can Be a Nightmare.

KFF Health News Original

Few nursing homes are set up to care for people needing help breathing with a ventilator because of ALS or other infirmities. Insurers often resist paying for ventilators at home, and innovative programs are now endangered by Medicaid cuts.

Medicaid Work Rules Exempt the ‘Medically Frail.’ Deciding Who Qualifies Is Tricky.

KFF Health News Original

People on Medicaid deemed “medically frail” won’t need to meet new federal requirements that enrollees work 80 hours a month or perform another approved activity. But state officials are grappling with how to interpret who qualifies under the vague federal definition, which could affect millions.

After Series of Denials, His Insurer Approved Doctor-Recommended Cancer Care. It Was Too Late.

KFF Health News Original

Eric Tennant’s doctors recommended histotripsy, which would target, and potentially destroy, a cancerous tumor in his liver. But by the time his insurer approved the treatment, Tennant was no longer considered a good candidate. He died in September.

What the Health? From KFF Health News: The GOP Circles the Wagons on ACA

Podcast

Republicans are solidifying their opposition to extending pandemic-era subsidies for Affordable Care Act plans and seem to be coalescing around giving money directly to consumers to spend on health care. Meanwhile, HHS Secretary Robert F. Kennedy Jr. continues to leave his mark on the agency, with the CDC altering its website to suggest childhood vaccines could play a role in causing autism. Paige Winfield Cunningham of The Washington Post, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Shefali Luthra of The 19th join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews Avik Roy.

Complaints About Gaps in Medicare Advantage Networks Are Common. Federal Enforcement Is Rare.

KFF Health News Original

Health systems drop out of Medicare Advantage plans all the time. Yet government documents obtained by KFF Health News show that federal regulators rarely warn plans that their networks of health providers are so skimpy they violate legal requirements.

Ticked Off Over Preauthorization: Walk-In Patient Avoided Lyme Disease but Not a Surprise Bill

KFF Health News Original

A Maine woman sought care at a clinic for a tick bite, then paid full price after her insurer denied coverage. Its reason? She didn’t have preapproval for the walk-in visit, even though testing later detected the pathogen that causes Lyme disease.