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Most Medicare enrollees likely were not paying a monthly average of $400 — as President Joe Biden stated — before the insulin cap took effect. However, because costs and other factors result in widely varying prices, some Medicare enrollees might have paid that much in a given month.
Starting this year, federal employees can choose plans that cover a broad menu of fertility services, including up to $25,000 annually for in vitro fertilization procedures. At the same time, politics around IVF and reproductive health have become a central issue in the current election-year debate.
Insurance agents say it’s too easy to access consumer information on the Affordable Care Act federal marketplace. Policyholders can lose their doctors and access to prescriptions. Some end up owing back taxes.
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
The Supreme Court this week heard its first abortion case since overturning Roe v. Wade in 2022, about an appeals court ruling that would dramatically restrict the availability of the abortion pill mifepristone. But while it seems likely that this case could be dismissed on a technicality, abortion opponents have more challenges in the pipeline. Meanwhile, health issues are heating up on the campaign trail, as Republicans continue to take aim at Medicare, Medicaid, and the Affordable Care Act — all things Democrats are delighted to defend. Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet, and Lauren Weber of The Washington Post join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KFF Health News’ Tony Leys, who wrote a KFF Health News-NPR “Bill of the Month” feature about Medicare and a very expensive air-ambulance ride. Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too.
A California law that takes effect this summer will grant minors on public insurance the ability to get mental health treatment without their parents’ consent, a privilege that their peers with private insurance have had for years. But the law has become a flashpoint in the state’s culture wars.
It’s estimated that an older patient can spend three weeks of the year getting care — and that doesn’t count the time it takes to arrange appointments or deal with insurance companies.
Used to operating with scarce resources, Montana Medicaid providers say gaps in state payments have left them struggling further.
There are legal safeguards to protect patients from big bills like out-of-network air-ambulance rides. But insurers may not pay if they decide the ride wasn’t medically necessary.
A state policy to extend Medi-Cal to qualified Californians without legal residency is running up against a federal requirement to resume eligibility checks. The redetermination process is causing many Latinos, who make up a majority of Medi-Cal beneficiaries, to be disenrolled.
Saturday marks the 14th anniversary of the still somewhat embattled Affordable Care Act. Health and Human Services Secretary Xavier Becerra joins host Julie Rovner to discuss the accomplishments of the health law — and the challenges it still faces. Also this week, Alice Miranda Ollstein of Politico, Tami Luhby of CNN, and Mary Agnes Carey of KFF Health News join Rovner to discuss what should be the final funding bill for HHS for fiscal 2024, next week’s Supreme Court oral arguments in a case challenging abortion medication, and more. Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too.
Savings estimated by the Congressional Budget Office from allowing the federal government to negotiate Medicare drug prices are based on a 10-year cumulative projection.
Republican Gov. Brian Kemp’s Georgia Pathways to Coverage program has seen anemic enrollment while chalking up millions in start-up costs — largely in technology and consulting fees. Critics say the money’s being wasted on a costly and ineffective alternative to Obamacare’s Medicaid expansion.
Demand for help monitoring patients’ vital signs remotely has taken off since a Medicare change in 2019. Dozens of companies now push the service to help overburdened primary care doctors — and as a revenue stream. But some policy experts say its growth has outpaced oversight and evidence of effectiveness.
One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of “qualifying life events.” But insurers’ contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.
Drugmakers offer copay assistance programs to patients, but insurers are tapping into those funds, not counting the amounts toward patient deductibles. That leads to unexpected charges. But the practice is under growing scrutiny.
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