Latest KFF Health News Stories
California Handed Its Medicaid Drug Program to One Company. Then Came a Corporate Takeover.
The company awarded the state’s Medi-Cal Rx contract was taken over by another company, Centene. That left the state with a contractor it didn’t pick — one that has been accused of overbilling nine other state Medicaid programs and is now under investigation by California.
KHN’s ‘What the Health?’: Finally, a Fix for the ‘Family Glitch’
President Joe Biden welcomed former President Barack Obama back to the White House this week to announce a new policy for the Affordable Care Act that would make subsidies available to more families with unaffordable employer coverage. Meanwhile, Congress struggled to find a compromise for continued federal funding of covid-19 vaccines, testing, and treatments. Tami Luhby of CNN, Shefali Luthra of The 19th, and Jessie Hellmann of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more.
The End of the Covid Emergency Could Mean a Huge Loss of Health Insurance
It is a perilous time to throw low- and middle-income Americans off the insurance cliff: A new omicron subvariant is spreading, and a program that provided coronavirus testing and covid-19 treatment at no cost to the uninsured has expired.
ACA Sign-Ups for Low-Income People Roll Out Amid Brokers’ Concerns About Losing Their Cut
The Biden administration unveiled a new special enrollment option aimed at signing up low-income Americans for Affordable Care Act coverage — even if it is outside of the usual annual open enrollment period. But insurers are cutting broker commissions at the same time.
Patients’ Perilous Months-Long Waiting for Medicaid Coverage Is a Sign of What’s to Come
The pandemic crisis has overwhelmed understaffed state Medicaid agencies, already delaying access to the insurance program in Missouri. As the public health emergency ends, low-income people nationwide could find it even harder to have coverage.
KHN’s ‘What the Health?’: Funding for the Next Pandemic
In his proposed budget, President Joe Biden called for a boost in health spending that includes billions of dollars to prepare for a future pandemic. But that doesn’t include money he says is needed immediately for testing and treating covid-19. Also this week, federal regulators authorized a second booster shot for people 50 and older yet gave little guidance to consumers about who needs the shot and when. Amy Goldstein of The Washington Post, Jennifer Haberkorn of the Los Angeles Times, and Rachana Pradhan of KHN join KHN’s Mary Agnes Carey to discuss these issues and more. Plus, Julie Rovner interviews KHN’s Julie Appleby, who reported and wrote the latest KHN-NPR “Bill of the Month” episode about a very expensive air ambulance ride.
The Case of the $489,000 Air Ambulance Ride
Diagnosed with aggressive leukemia on a Western trip, a young man thought his insurance would cover an air ambulance ride home to North Carolina. Instead, questions about medical necessity left him with an astronomical bill.
Cómo evitar facturas médicas sorpresa… y las “trampas” de la nueva ley
Aunque una ley supuestamente protege a los pacientes de las cuentas sorpresa, también tiene grietas por donde pasa la trampa.
How to Avoid Surprise Bills — And the Pitfalls in the New Law
The No Surprises Act offers protection from many surprise medical bills — but that protection may be only as good as a patient’s knowledge of the law and ability to make sure it’s enforced. Here’s what you need to know.
Medicare Advantage Plans Send Pals to Seniors’ Homes for Companionship — And Profits
Many Medicare Advantage plans send caregivers to the homes of seniors periodically to help with housework and provide companionship. But the workers may also prod seniors into activities that boost the plans’ Medicare ratings and federal reimbursements.
Want Vulnerable Californians to Have Healthier Pregnancies? Doulas Say the State Must Pay Up.
California was supposed to start paying doulas this year to help Medicaid enrollees have healthy pregnancies. But the benefit has been delayed because doulas feel lowballed by the state’s proposed reimbursement rate, which is below what most other states pay.
La medicación para prevenir el VIH debe ser gratis, pero las aseguradoras siguen cobrándola
Una norma federal estableció que los pacientes no debían pagar por la medicación para prevenir el VIH. Pero las aseguradoras siguen enviando facturas por los fármacos y servicios médicos asociados.
Seeking to Shift Costs to Medicare, More Employers Move Retirees to Advantage Plans
Private and public employers are increasingly using the government’s Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the “overwhelming majority” of medical costs, according to an industry analyst.
HIV Preventive Care Is Supposed to Be Free in the US. So, Why Are Some Patients Still Paying?
The Department of Labor issued rules in July clarifying that health plans need to cover the costs of prescription drugs proven to prevent HIV infection, along with related lab tests and medical appointments, at no cost to patients. More than half a year later, the erroneous billing continues.
The Demise of Single-Payer in California Trips Up Efforts in Other States
The failure of single-payer health care legislation in California casts doubt on the ability of other states to pass government-run, universal health care. But activists in New York, Washington state, and elsewhere say they are taking lessons from California and changing their tactics.
Plan to Fix Postal Service Shifts New Retirees to Medicare — Along With Billions in Costs
After a years-long bitter partisan fight over reforming the U.S. Postal Service’s finances and service, congressional leaders say they have a compromise. The bill, which has won endorsements from both Republicans and Democrats on Capitol Hill, would force future Postal Service retirees to use Medicare as their primary source of health coverage.
Changes to Medi-Cal’s Troubled Drug Program Reduce Backlog in California, but Problems Persist
After a troubled start to the new Medi-Cal prescription drug program, the state’s contractor has hired staffers to reduce wait times for medication approvals and patients seeking help. But some doctors and clinics report that patients continue to face delays.
KHN’s ‘What the Health?’: Contemplating a Post-‘Roe’ World
In anticipation of the Supreme Court rolling back abortion rights this year, both Democrats and Republicans are arguing among themselves over how best to proceed to either protect or restrict the procedure. Meanwhile, millions of Americans are at risk of losing their health insurance when the federal government declares an end to the current “public health emergency.” Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Rachana Pradhan of KHN join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KHN’s Jay Hancock, who wrote the latest KHN-NPR “Bill of the Month” episode about a couple whose insurance company deemed their twins’ stay in intensive care not an emergency.
Other States Keep Watchful Eye on Snags in Washington’s Pioneering Public-Option Plan
Washington was the first state in the U.S. to introduce a public option for health insurance, but the rollout hasn’t been smooth. Other states with public options in the works are taking notice.
An $80,000 Tab for Newborns Lays Out a Loophole in the New Law to Curb Surprise Bills
The insurance company said that the birth of the Bull family’s twins was not an emergency and that NICU care was “not medically necessary.” The family’s experience with a huge bill sent to collections happened in 2020, but it exposes a hole in the new No Surprises law that took effect Jan. 1.
