Journalists Tackle the Midterms and Open Enrollment
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.
Insurance
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Stopping the Churn: Why Some States Want to Guarantee Medicaid Coverage From Birth to Age 6
Oregon has become the first state to allow kids to stay in the government health care program from birth to age 6, no matter if their household income changes. California, Washington, and New Mexico are pursuing similar policies.
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South Dakota Voters Approved Medicaid Expansion, but Implementation May Not Be Easy
South Dakotans voted to expand the state’s Medicaid program to cover thousands of additional low-income residents. But as other conservative states have shown, voter approval doesn’t always mean politicians and administrators will rush to implement the change.
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Defense Department Health Plan Cuts Its Pharmacy Network by Nearly 15,000 Outlets
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.
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KHN’s ‘What the Health?’: ACA Open Enrollment Without the Drama
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.
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Cash for Colonoscopies: Colorado Tries to Lower Health Costs Through Incentives
State employees could receive checks ranging from $50 to thousands of dollars if they choose the right provider.
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This Open Enrollment Season, Look Out for Health Insurance That Seems Too Good to Be True
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.
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Shopping for ACA Health Insurance? Here’s What’s New This Year
Consumers may find relief in some key changes made by Congress and the Biden administration, although other issues remain unsettled.
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Montana Backs Away From Innovative Hospital Payment Model. Other States Are Watching.
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.
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Readers and Tweeters Take Positions on Sleep Apnea Treatment
KHN gives readers a chance to comment on a recent batch of stories.
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Employers Are Concerned About Covering Workers’ Mental Health Needs, Survey Finds
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.
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A Billing Expert Saved Big After Finding an Incorrect Charge in Her Husband’s ER Bill
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.
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Kids’ Mental Health Care Leaves Parents in Debt and in the Shadows
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.
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Campaigning Ramps Up as South Dakota Voters Decide on Medicaid Expansion
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.
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After Congress Fails to Add Dental Coverage, Medicare Weighs Limited Benefit Expansion
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.
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Lawsuit by KHN Prompts Government to Release Medicare Advantage Audits
The lawsuit was filed three years ago to learn about vast overcharges by the popular health plans that are detailed in audits the government refused to release to the public.
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KHN’s ‘What the Health?’: Finally Fixing the ‘Family Glitch’
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.
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Baby, That Bill Is High: Private Equity ‘Gambit’ Squeezes Excessive ER Charges From Routine Births
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.
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As Giant Hospitals Get Bigger, an Independent Doctor Feels the Pinch
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.
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New Generation of Weight Loss Medications Offer Promise — But at a Price
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.