Insurance Archives - Page 36 of 187

A photo illustration of a doctor filling out a form on a clipboard placed on a blue textured backdrop.

Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients

The federal government wants to change the way health insurers use prior authorization — the requirement that patients get permission before undergoing treatment. Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization has become a confusing maze that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New rules may not be enough to solve the problems.

By Lauren Sausser

March 13, 2023

A photo illustration shows a woman handing over a health insurance card over an abstract background of a pulse reading.

Medicaid Health Plans Try to Protect Members — And Profits — During Unwinding

States are turning to the big health insurance companies to keep Medicaid enrollees insured once pandemic protections end in April. The insurers’ motive: profits.

By Phil Galewitz

March 9, 2023

A photo of protesters holding signs that read, "Stop pharma's price abuse" and "Diabetes community dying."

Why Does Insulin Cost So Much? Big Pharma Isn’t the Only Player Driving Prices

Big Pharma may be moving on from squeezing diabetes patients on insulin prices, but it’s the arbitrators that jack up prices for those who can least afford them.

By Arthur Allen

March 9, 2023

What the Health? From KFF Health News

March Medicaid Madness

Episode 287

March 2, 2023

President Joe Biden and Republicans in Congress spent last month sparring over whether to shield Medicare and Social Security from budget cuts — leading some to wonder if Medicaid was on the table instead. Biden and Democrats say no, but some Republicans seem eager to trim federal spending on the health program for Americans with low incomes. And ready or not, artificial intelligence is coming to medical care. Benefits, as well as unintended consequences, are likely. Alice Miranda Ollstein of Politico, Rachel Cohrs of STAT News, and Lauren Weber of The Washington Post join KHN’s chief Washington correspondent, Julie Rovner, to discuss these issues and more.

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After People on Medicaid Die, Some States Aggressively Seek Repayment From Their Estates

States take drastically different approaches to recovering Medicaid money from deceased participants’ estates. Demands for repayment of Medicaid spending can drain the assets a person leaves behind, depending on where they lived.

By Tony Leys

March 2, 2023

Carolina Morga Tapia stands outside in a park with her five children. Two of the youngest are sitting in a green wagon.

Faces of Medi-Cal

California’s Massive Medicaid Program Works for Some, but Fails Many Others

Medi-Cal serves more than one-third of the state’s population — offering a dizzying range of care to a diverse population. In the new “Faces of Medi-Cal” series, California Healthline will assess the program’s strengths and weaknesses through the lives and experiences of its enrollees.

By Angela Hart and Bernard J. Wolfson

March 2, 2023

A photo shows President Joe Biden speaking at a podium while blurred hands hold up cellphones in the foreground.

Biden Promises to Fight GOP on ‘Gutting’ Medicaid. Budget Talks Seem Like Another Story.

As many lower-income Americans prepare to lose pandemic-era access to Medicaid, President Joe Biden vowed to stop Republicans from making deeper cuts to lower the national debt. Other changes may still be up for discussion.

By Michael McAuliff

March 1, 2023

An illustration shows the shape of Idaho next to a red rubber ink stamp that reads, "disenrolled."

Idaho Dropped Thousands From Medicaid in the Pandemic’s First Years

The removals, detailed in emails between state and federal health officials, hinged on disagreements over how states could disenroll people during the public health emergency. Consumer advocates fear the alleged violation signals the mess to come on April 1, when the pandemic-era Medicaid coverage mandate ends.

By Rachana Pradhan

March 1, 2023

A photo shows a woman holding her infant child while facing a window.

Bill Of The Month

Surprise-Billing Law Loophole: When ‘Out of Network’ Doesn’t Quite Mean Out of Network

Billing experts and lawmakers are playing catch-up as providers find ways to get around new surprise-billing laws, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.

By Harris Meyer

Feb. 28, 2023

A photo shows a woman posing for a portrait outside by a fence.

California Explores Private Insurance for Immigrants Lacking Legal Status. But Is It Affordable?

Nearly half a million Californians without legal residency make too much to qualify for Medicaid yet they can’t afford to buy coverage. A state lawmaker is proposing to open up the state’s health insurance exchange as a first step to providing them affordable insurance.

By Rachel Bluth

Feb. 27, 2023

Letters to the Editor

Readers and Tweeters Urgently Plea for a Proper ‘Role’ Call in the ER

KHN gives readers a chance to comment on a recent batch of stories.

Feb. 27, 2023

KHN & PolitiFact HealthCheck

Proposed Medicare Advantage Changes Cannot Accurately Be Called ‘Cuts,’ Experts Say

CMS advanced two proposed changes that could affect Medicare Advantage plans. One would allow the government to recover past overpayments. As a result, it could reduce those insurers’ profits, leading them to increase enrollees' out-of-pocket costs or reduce benefits. But it's inaccurate to characterize the changes as "cuts."

By Madison Czopek, PolitiFact and Yacob Reyes, PolitiFact

Feb. 22, 2023

A photo shows an older woman sitting in a chair and looking to the left.

A Bitter Battle Over the ‘Orphan Drug’ Program Leaves Patients’ Pocketbooks at Risk

Patients who depend upon special drugs to treat rare diseases are caught in the crossfire as drugmakers and the FDA battle over regulations that reward companies for developing treatments for relatively small pools of patients.

By Sarah Jane Tribble

Feb. 22, 2023

Watch: In Insurers’ Eyes, Not All Midwives Are Equal

The first installment of InvestigateTV and KHN’s “Costly Care” series explores one California mother’s experience struggling to get reimbursed for midwifery care and the differences between providers that may determine whether insurance covers them.

Feb. 15, 2023

Three photos are shown side-by-side. From left to right are a photo of a covid vaccine; a photo of a covid rapid test; a photo of Paxlovid.

COVID-19

Era of ‘Free’ Covid Vaccines, Test Kits, and Treatments Is Ending. Who Will Pay the Tab Now?

Insurers, employers, and taxpayers will all be affected as drug manufacturers move these products to the commercial market.

By Julie Appleby

Feb. 10, 2023

What the Health? From KFF Health News

A Health-Heavy State of the Union

Episode 284

Feb. 9, 2023

President Joe Biden’s 2023 State of the Union address leaned heavily on health care issues. Biden took a victory lap for recent accomplishments like capping prescription drug costs for seniors on Medicare. He also urged Congress to make permanent the boosted premium subsidies under the Affordable Care Act, and he sparred with Republicans on threats to cut Social Security and Medicare. Also this week, both sides in the abortion debate are bracing for a court decision out of Texas that could, at least temporarily, make the abortion pill mifepristone illegal nationwide. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Sarah Karlin-Smith of the Pink Sheet join KHN chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Kate Baicker of the University of Chicago about a possible middle ground in the effort to get universal health insurance coverage.

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Centene Agrees to $215 Million Settlement With California for Alleged Medicaid Overbilling

The nation’s largest Medicaid insurer denies wrongdoing after the California attorney general’s office investigated it for inflating prescription drug costs.

By Samantha Young

Feb. 8, 2023

A photo shows President Biden speaking during the State of the Union address.

Health Policies Were a Prominent Theme in Biden’s State of the Union Speech

Our partners at PolitiFact fact-checked a range of President Joe Biden’s statements, including key health-related comments.

By KFF Health News and PolitiFact staffs

Feb. 8, 2023

A photo shows Senator Bernie Sanders speaking into a microphone in front of the U.S. Capitol.

‘We Ain’t Gonna Get It’: Why Bernie Sanders Says His ‘Medicare for All’ Dream Must Wait

As he takes the reins of the Senate Health, Education, Labor & Pensions Committee, the independent from Vermont and implacable champion of “Medicare for All” maps out his strategy for negotiating with Republicans — and Big Pharma.

By Arthur Allen

Feb. 8, 2023