Latest Morning Briefing Stories

Medicare Plan Finder Likely Won’t Note New $35 Cap on Out-of-Pocket Insulin Costs

KFF Health News Original

In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.

California Stockpiles Penalties From Uninsured Residents Instead of Lowering Care Costs

KFF Health News Original

California is collecting hundreds of millions of dollars a year in tax penalties from uninsured residents. The state was supposed to use the money to help lower costs for Californians who couldn’t afford insurance but hasn’t distributed any of the revenue it has collected — citing uncertain economic times.

‘An Arm and a Leg’: No Money, No Job, No Health Care? Not Always.

KFF Health News Original

For many Americans, it’s open enrollment season for 2023 health insurance. One listener asked: If you don’t have a job and are too old to be on your parents’ plan, does it make sense to rely on charity care? This episode breaks it all down.

Stopping the Churn: Why Some States Want to Guarantee Medicaid Coverage From Birth to Age 6

KFF Health News Original

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.

South Dakota Voters Approved Medicaid Expansion, but Implementation May Not Be Easy

KFF Health News Original

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.

Defense Department Health Plan Cuts Its Pharmacy Network by Nearly 15,000 Outlets

KFF Health News Original

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.

KHN’s ‘What the Health?’: ACA Open Enrollment Without the Drama

KFF Health News Original

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.

This Open Enrollment Season, Look Out for Health Insurance That Seems Too Good to Be True

KFF Health News Original

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.

¿Comprando seguro de salud de ACA? Aquí, lo nuevo de este año  

KFF Health News Original

Comprar ahora significa tener cobertura vigente a partir del 1o de enero de 2023.  Aunque gran parte de los planes permanecen iguales año tras año , hay algunos cambios que los consumidores deben tener en cuenta.

Montana Backs Away From Innovative Hospital Payment Model. Other States Are Watching.

KFF Health News Original

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.

Employers Are Concerned About Covering Workers’ Mental Health Needs, Survey Finds

KFF Health News Original

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.

A Billing Expert Saved Big After Finding an Incorrect Charge in Her Husband’s ER Bill

KFF Health News Original

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.

Kids’ Mental Health Care Leaves Parents in Debt and in the Shadows

KFF Health News Original

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.