Readers Rail at Social Security Overpayments and Insurers’ Prior Authorizations
KFF Health News gives readers a chance to comment on a recent batch of stories.
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New Medicare Advantage Plans Tailor Offerings to Asian Americans, Latinos, and LGBTQ+
As more seniors opt for Medicare Advantage, a few small insurers have begun offering plans that provide culturally targeted benefits for cohorts including Asian Americans, Latinos, and LGBTQ+ people. The approach, policy researchers say, has potential and perils.
More Medicaid Messiness
Episode 316At least 30 states are reinstating coverage for children wrongly removed from the rolls under Medicaid redetermination, the federal government reported. It’s just the latest hiccup in the massive effort to review the eligibility of Medicaid beneficiaries now that the program’s pandemic-era expansion has expired. And federal oversight of the so-called unwinding would be further complicated by an impending government shutdown. Rachel Roubein of The Washington Post, Sandhya Raman of CQ Roll Call, and Sarah Karlin-Smith of Pink Sheet join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KFF Health News’ Samantha Liss, who reported and wrote the latest KFF Health News-NPR “Bill of the Month” feature, about a hospital bill that followed a deceased patient’s family for more than a year.
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What Happens to Health Programs if the Federal Government Shuts Down?
Medicare and Medicaid shouldn’t be affected, but confusion can be expected.
By Julie Rovner -
How Will Rural Americans Fare During Medicaid Unwinding? Experts Fear They’re on Their Own
As states review their Medicaid rolls after the expiration of a pandemic-era prohibition against kicking recipients off the government insurance program, experts say the lack of help available to rural Americans in navigating insurance options puts them at greater risk of losing health coverage than people in metropolitan areas.
Underinsured Is the New Uninsured
Episode 314The percentage of working-age adults with health insurance went up and the uninsured rate dropped last year, the U.S. Census Bureau reported this week. There isn’t much suspense about which way the uninsured rate is now trending, as states continue efforts to strip ineligible beneficiaries from their Medicaid rolls. But is the focus on the uninsured obscuring the struggles of the underinsured? Margot Sanger-Katz of The New York Times, Sarah Karlin-Smith of the Pink Sheet, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KFF Health News’ Emmarie Huetteman to discuss these issues and more.
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As More Patients Email Doctors, Health Systems Start Charging Fees
Doctors say billing for email consultations reduces message volume and gives them more free time. The increasingly prevalent practice has also raised fears about negative impacts to patient care.
By Harris Meyer -
Pfizer and Moderna Are Pushing the New Covid Booster. Should You Get It? The CDC Is About to Decide.
Chances are, if you aren’t older, chronically ill, or obese, you don’t need a forthcoming covid vaccine to stay out of the hospital. But it probably wouldn’t hurt.
By Arthur Allen -
Hollywood’s A-List Health Insurance Is Jeopardized by the Labor Strikes
Hollywood actors and writers who qualify for their union health plans get a very good deal compared with other Americans. But not working during the strike threatens their eligibility in the system.
3 Health Policy Experts You Should Know
Episode 312In this special episode of KFF Health News’ “What the Health?” host Julie Rovner interviews three health policy experts.
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She Paid Her Husband’s Hospital Bill. A Year After His Death, They Wanted More Money.
A widow encountered a perplexing reality in medical billing: Providers can come after patients to collect well after a bill has been paid.
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Timing and Cost of New Vaccines Vary by Virus and Health Insurance Status
Flu. Covid. RSV. When and how to get vaccinated against them can be confusing. Here are some of the most important things to know.
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After Backlash, Feds Cancel Plan That Risked Limiting Breast Reconstruction Options
The Centers for Medicare & Medicaid Services backed off from a plan that could have curtailed access to a type of reconstructive surgery known as DIEP flap. Breast cancer patient advocates are relieved.
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Doctors and Patients Try to Shame Insurers Online to Reverse Prior Authorization Denials
Prior authorization is a common tool used by health insurers for many tests, procedures, and prescriptions. Frustrated by the process, patients and doctors have turned to social media to publicly shame insurance companies and elevate their denials for further review.
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A New Medicare Proposal Would Cover Training for Family Caregivers
The federal government is proposing having Medicare pay professionals to train family caregivers how to perform tasks like bathing and dressing their loved ones, and properly use medical equipment.
On Abortion Rights, Ohio Is the New Kansas
Episode 309Nearly a year to the day after Kansas voters surprised the nation by defeating an anti-abortion ballot question, Ohio voters defeated a similar, if cagier, effort to limit access in that state. This week, they rejected an effort to raise the threshold for approval of future ballot measures from a simple majority, which would have made it harder to protect abortion access with yet another ballot question come November. Meanwhile, the number of Americans without health insurance has dropped to an all-time low, though few noticed. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Rachel Roubein of The Washington Post, and Emmarie Huetteman of KFF Health News join KFF Health News’ chief Washington correspondent, Julie Rovner, to discuss these issues and more. Also this week, Rovner interviews Kate McEvoy, executive director of the National Association of Medicaid Directors, about how the “Medicaid unwinding” is going, as millions have their eligibility for coverage rechecked.
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Lost Medicaid Health Coverage? Here’s What You Need to Know
Patient advocates are tackling the “overwhelming task” of connecting people with health insurance as millions lose coverage due to the end of pandemic protections on Medicaid eligibility.
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His Anesthesia Provider Billed Medicare Late. He Got Sent to Collections for the $3,000 Tab.
Medicare was supposed to cover the entire cost of his procedure. But after the anesthesia provider failed to file its claims in a timely manner, it billed the patient instead.
Another Try for Mental Health ‘Parity’
Episode 307President Joe Biden is kicking off his reelection campaign in part by trying to finish a decades-long effort to establish parity in insurance benefits between mental and physical health. Meanwhile, House Republicans are working to add abortion and other contentious amendments to must-pass spending bills. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Anna Edney of Bloomberg, and Sarah Karlin-Smith of the Pink Sheet join KFF Health News’ chief Washington correspondent, Julie Rovner, to discuss these issues and more. Also this week, Rovner interviews KFF Health News’ Céline Gounder about her podcast “Epidemic.” The new season focuses on the successful public health effort to eradicate smallpox.
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Covered California to Cut Patient Costs After Democratic Lawmakers Win Funding From Gov. Newsom
California’s health insurance exchange will reduce how much some patients pay for care next year, including hospital deductibles, appointment copays, and prescription drugs. Lawmakers pressed Gov. Gavin Newsom to make good on a four-year-old pledge to use proceeds from a tax penalty on uninsured people to help people pay for treatment.
By Angela Hart