Direct Primary Care, With a Touch of Robin Hood
Some doctors, sick of mainstream health care’s red tape, are finding refuge in practices that combine concierge medicine with charity care.
Insurance
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KHN’s ‘What the Health?’: Dems Agree to Agree, But Not on What to Agree On
Negotiations on the health parts of President Joe Biden’s domestic agenda are getting serious but have yet to produce a deal every Democrat can support. Meanwhile, the Food and Drug Administration remains without a nominated leader but manages to take the first steps toward approving over-the-counter hearing aids. Joanne Kenen of Politico and Johns Hopkins, Tami Luhby of CNN and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these issues and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too.
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‘An Arm and a Leg’: Hello? We Spend 12 Million Hours a Week on the Phone With Insurers
In this episode, we get our bearings on self-funded insurance plans, and how they affect the average — sometimes burned-out — American worker trying to get answers about insurance.
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How to Crush Medical Debt: 5 Tips for Using Hospital Charity Care
The law says nonprofit hospitals are supposed to offer low-income patients financial assistance. But the average person doesn’t know about it. Here’s how to get help.
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Insurance Focused on Virtual Visits? The Pros and Cons of a New Twist in Health Plans
New, often lower-cost plans capitalize on the convenience of telemedicine — and patients’ growing familiarity with it. But consumers should weigh costs and care options before enrolling in a “virtual-first” plan.
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Surprise-Billing Rule ‘Puts a Thumb on the Scale’ to Keep Arbitrated Costs in Check
Patients soon will not have to worry about the prospect of these often-costly unexpected bills, a federal law promises. Some experts say the new policy could also slow the growth of health insurance premiums.
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Health Industry Wields Power in California’s High-Stakes Battle to Lower Health Care Costs
Gov. Gavin Newsom wants to regulate out-of-control health care spending in California. The effort is being shaped by the very health industry players that would be regulated.
By Angela Hart and Samantha Young -
Major Insurers Running Billions of Dollars Behind on Payments to Hospitals and Doctors
Patients are caught in the middle as insurers clamp down on paying for treatments or force prior authorizations for care.
By Jay Hancock -
Perspectives
The Pandemic Forced My Transgender Wife to Fight Our Insurer Over Hormones
The covid pandemic has caused millions of people, particularly LGBTQ adults, to lose their jobs and enroll in Medicaid or insurance through the Affordable Care Act. Yet these plans often don’t fully cover the basics needed by many transgender Americans, such as injectable estrogen, a hormone therapy commonly used by trans women.
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Journalists Drill Down on Covid Vaccine Boosters, Misinformation Online
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.
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Death in Dallas: One Family’s Experience in the Medicaid Gap
Efforts to give 2.2 million Americans health insurance hang in the balance as Congress debates a massive spending bill. The so-called Medicaid gap is felt most acutely in Texas, where about half of those who stand to gain coverage live.
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A Covid Test Costing More Than a Tesla? It Happened in Texas.
A patient from Dallas got a PCR test in a free-standing suburban emergency room. The out-of-network charge: $54,000.
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As Democrats Bicker Over Massive Spending Plan, Here’s What’s at Stake for Medicaid
More than 2 million low-income adults are uninsured because their states have not accepted Medicaid expansion under the Affordable Care Act. Congressional Democrats want to offer them coverage in the massive spending bill being debated, but competition to get into that package is fierce.
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‘An Arm and a Leg’: They Turned Grief Into Action
This episode highlights how New York enacted a charity care law, one of the precursors to the federal provision on charity care in the Affordable Care Act.
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The Solution to Au Pairs’ Health Coverage Gaps May Be Simple: ACA Plans
Private agencies that bring young adults to the U.S. to care for children generally offer basic health insurance, but plans may exclude many types of necessary care. What the agencies might not mention is that au pairs are eligible to enroll in comprehensive coverage on the Affordable Care Act marketplaces and likely qualify for premium subsidies that would make the insurance affordable.
By Bryce Covert -
Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans
The plans are designed for people who don’t get dental coverage through their jobs and can’t afford an individual plan. For about $300 to $400 a year, patients receive certain preventive services at no charge and other procedures at a discount.
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Leader of California’s Muscular Obamacare Exchange to Step Down
Peter Lee helped create Covered California, which has been lauded as a national example among the Affordable Care Act’s insurance marketplaces, and he fiercely opposed Republican efforts to repeal the federal health reform law.
By Bernard J. Wolfson and Angela Hart -
KHN’s ‘What the Health?’: Much Ado About Drug Prices
Democrats have hit a snag in their effort to compile a $3.5 trillion social-spending bill this fall — moderates are resisting support for Medicare drug price negotiation provisions that would pay for many of the measure’s health benefit improvements. Meanwhile, the new abortion restrictions in Texas have moved the divisive issue back to the political front burner. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat and Shefali Luthra of The 19th join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interview’s KHN’s Phil Galewitz about the latest KHN-NPR “Bill of the Month” installment, about two similar jaw surgeries with very different price tags.
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Census: Insured Population Holds Steady, With a Slight Shift From Private to Public Coverage
The Census Bureau on Tuesday released its 2020 findings regarding Americans’ income, poverty and health insurance coverage.
By Victoria Knight and Julie Appleby -
Health Care Unions Defending Newsom From Recall Will Want Single-Payer Payback
If Gov. Gavin Newsom survives Tuesday’s recall election, the health care unions that have campaigned on his behalf intend to pressure him to follow through on his promise to establish a government-run health system in California.
By Angela Hart