Latest Morning Briefing Stories

Out-of-Pocket Pain From High-Deductible Plans Means Skimping on Care

KFF Health News Original

High-deductible health insurance plans are increasingly common, and many more enrollees will likely need to choose such plans for the coming year. For those with chronic conditions like diabetes, the gamble can mean compromised care and long-term consequences.

Trump’s Idea for Health Accounts Has Been Tried. Millions of Patients Have Ended Up in Debt.

KFF Health News Original

Republican calls to give Americans cash instead of health insurance subsidies double down on a decades-old strategy of moving people into high-deductible plans with health savings accounts.

Watch: What Do Republicans Really Want on Health Care?

KFF Health News Original

On “What the Health? From KFF Health News,” distributed by WAMU, chief Washington correspondent and podcast host Julie Rovner sat down with Avik Roy, a GOP health policy adviser, to talk about how health care has evolved as a Republican Party issue.

They Need a Ventilator To Stay Alive. Getting One Can Be a Nightmare.

KFF Health News Original

Few nursing homes are set up to care for people needing help breathing with a ventilator because of ALS or other infirmities. Insurers often resist paying for ventilators at home, and innovative programs are now endangered by Medicaid cuts.

Medicaid Work Rules Exempt the ‘Medically Frail.’ Deciding Who Qualifies Is Tricky.

KFF Health News Original

People on Medicaid deemed “medically frail” won’t need to meet new federal requirements that enrollees work 80 hours a month or perform another approved activity. But state officials are grappling with how to interpret who qualifies under the vague federal definition, which could affect millions.

After Series of Denials, His Insurer Approved Doctor-Recommended Cancer Care. It Was Too Late.

KFF Health News Original

Eric Tennant’s doctors recommended histotripsy, which would target, and potentially destroy, a cancerous tumor in his liver. But by the time his insurer approved the treatment, Tennant was no longer considered a good candidate. He died in September.

What the Health? From KFF Health News: The GOP Circles the Wagons on ACA

Podcast

Republicans are solidifying their opposition to extending pandemic-era subsidies for Affordable Care Act plans and seem to be coalescing around giving money directly to consumers to spend on health care. Meanwhile, HHS Secretary Robert F. Kennedy Jr. continues to leave his mark on the agency, with the CDC altering its website to suggest childhood vaccines could play a role in causing autism. Paige Winfield Cunningham of The Washington Post, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Shefali Luthra of The 19th join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews Avik Roy.

Complaints About Gaps in Medicare Advantage Networks Are Common. Federal Enforcement Is Rare.

KFF Health News Original

Health systems drop out of Medicare Advantage plans all the time. Yet government documents obtained by KFF Health News show that federal regulators rarely warn plans that their networks of health providers are so skimpy they violate legal requirements.

Paciente evita la enfermedad de Lyme, pero recibe una factura sorpresa

KFF Health News Original

El personal de una clínica de urgencias encontró otra garrapata en el cuerpo de Leah durante esa visita. Pero su aseguradora no quiso pagar por el tratamiento.

Ticked Off Over Preauthorization: Walk-In Patient Avoided Lyme Disease but Not a Surprise Bill

KFF Health News Original

A Maine woman sought care at a clinic for a tick bite, then paid full price after her insurer denied coverage. Its reason? She didn’t have preapproval for the walk-in visit, even though testing later detected the pathogen that causes Lyme disease.

What the Health? From KFF Health News: The Government Is Open

Podcast

The record-long federal shutdown is over after a small group of Democrats agreed to a deal with most Republicans that funds the government through January — but, notably, does not extend more generous Affordable Care Act tax credits. Plus, new details are emerging about how the Trump administration is using the Medicaid program to advance its policy goals. Anna Edney of Bloomberg News, Shefali Luthra of The 19th, and Sandhya Raman of CQ Roll Call join KFF Health News’ Emmarie Huetteman to discuss these stories and more. Also this week, KFF Health News’ Julie Rovner interviews KFF Health News’ Julie Appleby, who wrote the latest “Bill of the Month” feature.

Health Care Costs Jump to the Fore as Candidates Jockey To Be California Governor

KFF Health News Original

During a California gubernatorial debate, candidates promised to protect people’s access to health care and fight back against Trump administration cuts. With the contest a year away, polling shows voters want the next governor to minimize out-of-pocket health care costs, increase mental health care, and expand caregiving services.

Shutdown Has Highlighted Washington’s Retreat From Big Ideas on Health Care

KFF Health News Original

As voters feel financial pressure from runaway health care costs and crave innovations that would provide relief, the standoff in Congress has been firmly rooted in the status quo — keeping an existing provision of the Affordable Care Act alive.