Insurance

Latest KFF Health News Stories

Defense Department Health Plan Cuts Its Pharmacy Network by Nearly 15,000 Outlets

KFF Health News Original

Many of the pharmacies were small, independent operations that had decided not to participate next year because of the lowered reimbursement being offered. But they were surprised by an early dismissal, and some patients with specialized drug needs could face difficulties in the transition.

KHN’s ‘What the Health?’: ACA Open Enrollment Without the Drama

KFF Health News Original

The Affordable Care Act’s 10th annual open-enrollment period began Nov. 1 and runs through Jan. 15, 2023, in most states. But for the first time, the health law seems to be enrolling Americans with far less controversy than in previous years. Meanwhile, as Election Day approaches, Democrats are focusing on GOP efforts to cut Social Security and Medicare. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Tami Luhby of CNN, and Julie Appleby of KHN join KHN’s Julie Rovner to discuss these topics and more. Also this week, Rovner interviews KHN’s Arthur Allen, who wrote the latest KNH-NPR Bill of the Month, about an old but still very expensive cancer drug.

This Open Enrollment Season, Look Out for Health Insurance That Seems Too Good to Be True

KFF Health News Original

Complaints about misleading health insurance marketing are soaring. State insurance commissioners are taking notice. They’ve created a shared internal database to monitor questionable business practices, and, in the future, they hope to provide a public-facing resource for consumers. In the meantime, consumers should shop wisely as open enrollment season begins.

¿Comprando seguro de salud de ACA? Aquí, lo nuevo de este año  

KFF Health News Original

Comprar ahora significa tener cobertura vigente a partir del 1o de enero de 2023.  Aunque gran parte de los planes permanecen iguales año tras año , hay algunos cambios que los consumidores deben tener en cuenta.

Montana Backs Away From Innovative Hospital Payment Model. Other States Are Watching.

KFF Health News Original

Montana has been a national model for how employers could gain control and transparency over medical bills. Upcoming changes to its model have health care price experts wondering whether the state is making improvements or losing focus.

Employers Are Concerned About Covering Workers’ Mental Health Needs, Survey Finds

KFF Health News Original

Nearly half of large employers report that increasing numbers of their workers were using mental health services, according to a KFF annual employer survey. Yet almost a third of those employers said their health plan’s network didn’t have enough behavioral health care providers for employees to have timely access to the care they need.

A Billing Expert Saved Big After Finding an Incorrect Charge in Her Husband’s ER Bill

KFF Health News Original

A medical billing specialist investigated her husband’s ER bill. Her sleuthing took over a year but knocked thousands of dollars off the hospital’s charges — and provides a playbook for other consumers.

Kids’ Mental Health Care Leaves Parents in Debt and in the Shadows

KFF Health News Original

A youth mental health crisis and a shortage of therapists and other care providers who take insurance are pushing many families into financial ruin. But it’s rarely acknowledged as medical debt.

Campaigning Ramps Up as South Dakota Voters Decide on Medicaid Expansion

KFF Health News Original

A broad coalition of Medicaid expansion supporters faces off against a smaller group of opponents as early voting begins on a constitutional amendment that would increase coverage under South Dakota’s program.

After Congress Fails to Add Dental Coverage, Medicare Weighs Limited Benefit Expansion

KFF Health News Original

Medicare can pay for some dental care if it is medically necessary to safely treat another covered medical condition, and federal officials have asked for suggestions on whether that list of conditions should be expanded.

KHN’s ‘What the Health?’: Finally Fixing the ‘Family Glitch’

KFF Health News Original

The Biden administration has decided to try to fix the so-called “family glitch” in the Affordable Care Act without an act of Congress. The provision has prevented workers’ families from getting subsidized coverage if an employer offer is unaffordable. Meanwhile, Medicare’s open enrollment period begins Oct. 15, and private Medicare Advantage plans are poised to cover more than half of Medicare’s 65 million enrollees. Margot Sanger-Katz of The New York Times, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these topics and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read.

La nueva generación de medicamentos para la pérdida de peso es prometedora, pero tiene un precio

KFF Health News Original

Algunos pacientes, según los especialistas en medicina de la obesidad, experimentan una disminución de la presión arterial, un mejor control de la diabetes, menos dolor en las articulaciones y un mejor sueño gracias a estos nuevos tratamientos.

New Generation of Weight Loss Medications Offer Promise — But at a Price

KFF Health News Original

People now have at their disposal more medicines that are effective at reducing weight, but none can counter obesity alone. One big problem: Insurance coverage remains spotty, and the costly drugs may be needed long term.

Baby, That Bill Is High: Private Equity ‘Gambit’ Squeezes Excessive ER Charges From Routine Births

KFF Health News Original

Hospitals, boosted by private equity-backed staffing companies, have embraced a new idea: the obstetrics emergency department. Often, it is just a triage room in the labor-and-delivery area, but it bills like the main emergency department.

As Giant Hospitals Get Bigger, an Independent Doctor Feels the Pinch

KFF Health News Original

Independent medical practices keep closing as doctors join behemoth hospital groups or leave the field. Research suggests that’s bad news for patients. Studies repeatedly conclude that consolidation in the health care industry is driving up costs while showing no clear evidence of improved care.