Category: Insurance

  • Journalists Put Polio, Price Transparency, and a Personal Covid Battle in Perspective

    KHN senior correspondent Arthur Allen discussed New York’s polio case with WBEZ’s “Reset With Sasha-Ann Simons” on Aug. 2. Click here to hear Allen on WBEZ Read Allen’s “What the Polio Case in New York Tells Us About the End of Polio” KHN senior correspondent Julie Appleby discussed health insurance price transparency rules that took […]

  • They Lost Medicaid When Paperwork Was Sent to an Empty Field, Signaling the Mess to Come

    BELFAST, Tenn. — Three years ago, Mason Lester, a rambunctious toddler, tumbled off his family’s porch and broke his wrist. His mother, nine months pregnant, rushed him to a nearby hospital, where she made a confounding discovery: Their health insurance had vanished. Alarmed, Katie Lester called the Tennessee Medicaid agency, TennCare, which had covered her […]

  • La crisis de deuda que los estadounidenses enfermos no pueden evitar

    La promesa de campaña del presidente Joe Biden de cancelar la deuda estudiantil por los primeros $10,000 adeudados en préstamos universitarios federales ha generado un debate sobre la equidad de estos programas de préstamos. En un sondeo de junio, poco más de la mitad de los estadounidenses encuestados apoyaron que se condonara la deuda universitaria, […]

  • Omicron BA.5 Surge: 5 Ways to Stay Safe

    The BA.5 surge is a reminder that we need to take precautions to avoid illness, slow the relentless cycle of new variants and minimize the disruption to our daily lives.

  • Ad Targeting Manchin and AARP Mischaracterizes Medicare Drug-Price Negotiations

    Sen. Joe Manchin and AARP “support government price-setting schemes” to divert money from Medicare to “unrelated government programs or pad big insurers’ profits.” Ad by American Commitment, July 10 A snappy political advertisement from the conservative advocacy group American Commitment bluntly charges Sen. Joe Manchin (D-W.Va.) with supporting a legislative plan that would drain “billions […]

  • KHN’s ‘What the Health?’: Drug Price Bill Is a Go in the Senate

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts. President Joe Biden is the latest top Washington official to test positive for covid-19, following Vice President Kamala Harris, Speaker of the House Nancy Pelosi, and Senate […]

  • A Free-for-All From Readers and Tweeters, From Medical Debt to Homelessness

    Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. It is appalling that an article like this even has to be written. Our “healthcare” system is broken.How to get rid of medical debt — or avoid it in the first […]

  • KHN’s ‘What the Health?’: Life After ‘Roe’ Is … Confusing

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts. The Supreme Court’s decision overturning the federal constitutional right to abortion has left confusion in its wake. State abortion laws are in constant flux, patients and providers […]

  • Patients With Epilepsy Navigate Murky Unregulated CBD Industry

    In 2013, Tonya Taylor was suicidal because her epileptic seizures persisted despite taking a long list of medications. Then a fellow patient at a Denver neurologist’s office mentioned something that gave Taylor hope: a CBD oil called Charlotte’s Web. The person told her the oil helped people with uncontrolled epilepsy. However, the doctor would discuss […]

  • Three Things to Know About Insurance Coverage for Abortion

    Will your health plan pay for an abortion now that the Supreme Court has overturned Roe v. Wade? Even before the June 24 ruling, insurance coverage for abortion varied widely. Now the issue is even more complex as states set varying rules — about half are expected to limit or ban abortion in almost all […]

  • In America, Cancer Patients Endure Debt on Top of Disease

    RAPID CITY, S.D. ― Jeni Rae Peters would make promises to herself as she lay awake nights after being diagnosed with breast cancer two years ago. “My kids had lost so much,” said Peters, a single mom and mental health counselor. She had just adopted two girls and was fostering four other children. “I swore […]

  • Journalists Explain the Effects of ‘Dobbs’ Decision and New Insurer Price Transparency Rules

    KHN chief Washington correspondent Julie Rovner discussed how the Supreme Court’s decision on abortion affects contraception on NPR/WAMU’s “1A” on July 6. Click here to hear Rovner on “1A” KHN senior correspondent Julie Appleby discussed insurer price transparency regulations on NPR’s “Weekend Edition Saturday” on July 2. Click here to hear Appleby on “Weekend Edition […]

  • ‘Free’ Screening? Know Your Rights to Get No-Cost Care

    An ounce of prevention … well, you know the rest. In medicine, prevention aims to spot problems before they worsen, affecting both a patient’s health and finances. One of the more popular parts of the Affordable Care Act, which allows patients to get certain tests or treatments without forking out cash to cover copayments or […]

  • Cómo evitar, o deshacerse, de una deuda médica

    Lori Mangum tenía 32 años cuando aparecieron tumores del tamaño de manzanas en su cabeza. Ahora, seis años y 10 cirugías después, el cáncer de piel desapareció. Pero su dolor sigue vivo, en la forma de una deuda médica. Incluso con seguro, Mangum pagó $36,000 de su bolsillo, cargos que surgieron del hospital, el cirujano, […]

  • How to Get Rid of Medical Debt — Or Avoid It in the First Place

    Lori Mangum was 32 when apple-size tumors sprouted on her head. Now — six years and 10 surgeries later — the skin cancer is gone. But her pain lives on, in the form of medical debt. Even with insurance, Mangum paid $36,000 out-of-pocket, charges that stemmed from the hospital, the surgeon, the anesthesiologist, the pharmacy, […]

  • Big Employers Are Offering Abortion Benefits. Will the Information Stay Safe?

    In response to the Supreme Court’s overturning of Americans’ constitutional right to abortion, large employers thought they had found a way to help workers living in states where abortions would be banned: provide benefits to support travel to other states for services. But that solution is only triggering questions. Experts warn that simply claiming the […]

  • Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

    Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday. Witnesses sharply criticized the fast-growing health plans at a hearing held by the Energy and Commerce subcommittee on oversight and investigations. […]

  • His-and-Hers Cataract Surgeries, But His Bill Was 20 Times as Much

    Danilo Manimtim’s vision was cloudy and blurred — and it was growing worse. The 73-year-old retired orthopedic surgeon in Fresno, California, knew it was time for cataract surgery. “It’s like car tires wearing out because you drive on them so much,” he said. In December 2021, he went to the outpatient department of the local […]

  • KHN’s ‘What the Health?’: The FDA Goes After Nicotine

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts. The FDA this week launched a crackdown on smoking and vaping — ordering the vaping device Juul to be taken off the market and announcing its intention […]

  • New Weight Loss Treatment Is Marked by Heavy Marketing and Modest Results

    First came the “edible billboard,” which appeared last year during the holidays in New York’s East Village loaded with cake treats. Then, in late January, came the national marketing campaign, with TV and digital media promoting the idea that trying to lose weight doesn’t mean a person can’t enjoy eating. Those advertising messages are pushing […]

  • States Extend Medicaid for New Mothers — Even as They Reject Broader Expansion

    Until last year, Georgia’s Medicaid coverage for new moms with low incomes lasted 60 days. That meant the Medicaid benefits of many women expired before they could be referred to other medical providers for help with serious health problems, said Dr. Keila Brown, an OB-GYN in Atlanta. “If they needed other postpartum issues followed up, […]

  • 100 Million People in America Are Saddled With Health Care Debt 

    Elizabeth Woodruff drained her retirement account and took on three jobs after she and her husband were sued for nearly $10,000 by the New York hospital where his infected leg was amputated. Ariane Buck, a young father in Arizona who sells health insurance, couldn’t make an appointment with his doctor for a dangerous intestinal infection […]

  • Preventive Care May Be Free, but Follow-Up Diagnostic Tests Can Bring Big Bills

    When Cynthia Johnson learned she would owe $200 out-of-pocket for a diagnostic mammogram in Houston, she almost put off getting the test that told her she had breast cancer. “I thought, ‘I really don’t have this to spend, and it’s probably nothing,’” said Johnson, who works in educational assessment at a university. But she decided […]

  • Lawmaker Takes on Insurance Companies and Gets Personal About His Health

    SACRAMENTO, Calif. — Scott Wiener made a startling revelation at a spring legislative committee hearing: “I was in the hospital. I experienced the most intense abdominal pain that I could even imagine.” The Democratic state senator recalled crawling up the stairs to his landlord’s apartment last July to get a ride to the hospital. The […]

  • They Thought They Were Buying Obamacare Plans. What They Got Wasn’t Insurance.

    Tina Passione needed health insurance in a hurry in December. The newly retired 63-year-old was relocating to suburban Atlanta with her husband to be closer to grandchildren. Their house in Pittsburgh flew off the market, and they had six weeks to move out 40 years of memories. Passione said she went online to search for […]

  • California Wants to Slash Insulin Prices by Becoming a Drugmaker. Can it Succeed?

    SACRAMENTO — California is diving into the prescription drug business, attempting to achieve what no other state has done: produce its own brand of generic insulin and sell it at below-market prices to people with diabetes like Sabrina Caudillo. Caudillo said she feels like a “prisoner” to the three major pharmaceutical companies that control the […]

  • AARP’s Billion-Dollar Bounty

    In September, AARP, the giant organization for older Americans, agreed to promote a burgeoning chain of medical clinics called Oak Street Health, which has opened more than 100 primary care outlets in nearly two dozen states. The deal gave Oak Street exclusive rights to use the trusted AARP brand in its marketing — for which […]

  • KHN’s ‘What the Health?’: Washington’s Slow Churn

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts. In the wake of three high-profile mass shootings in less than a month, lawmakers on Capitol Hill have renewed negotiations over legislation that could stem gun violence. […]

  • Readers and Tweeters Go to the Mat on Abortion Rights and Perceived Wrongs

    Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. Pulling No Punches on Abortion Reading the leaked draft opinion felt like a punch in the uterus (“Historic ‘Breach’ Puts Abortion Rights Supporters and Opponents on Alert for Upcoming Earthquake,” May […]

  • Computer Glitches and Human Error Still Causing Insurance Headaches for Californians

    Since California expanded health coverage under the Affordable Care Act, a large number of people have been mistakenly bounced between Covered California, the state’s marketplace for those who buy their own insurance, and Medi-Cal, the state’s Medicaid program for low-income residents. Small income changes can cause people’s eligibility to shift, but when bad information is […]

  • Her First Colonoscopy Cost Her $0. Her Second Cost $2,185. Why?

    Elizabeth Melville and her husband are gradually hiking all 48 mountain peaks that top 4,000 feet in New Hampshire. “I want to do everything I can to stay healthy so that I can be skiing and hiking into my 80s — hopefully even 90s!” said the 59-year-old part-time ski instructor who lives in the vacation […]

  • KHN’s ‘What the Health?’: Waking Up to Baby Formula Shortage

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The federal government finally addressed the infant formula shortage, as a growing number of families found themselves without anything to feed their babies. But it will likely […]

  • Coverage Discovery: how it works and benefits healthcare organizations

    U.S. hospitals have been stuck with more than $702 billion in uncompensated care costs for the past 2 decades, and the number continues to grow.  Other factors like patients relocating, changing employers, and coverage renewals make recovering debt even harder. The recent end in COVID-19 funding has also made it more important than ever for healthcare […]

  • New Covered California Leader Urges Renewal of Enhanced Federal Aid for Health Premiums

    When she was Pennsylvania’s insurance commissioner, Jessica Altman, the appointee of a Democratic governor, often bumped against the political limits of health care policy in a state where Republicans controlled the legislature. Despite the constraints of a divided government, Altman played a key role in persuading lawmakers in 2019 to join Gov. Tom Wolf in […]

  • KHN’s ‘What the Health?’: The Invisible Pandemic

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Covid-19 cases are on the rise again, but you couldn’t tell from the behavior of the public (rushing back to normal), as well as public health and […]

  • Even When IVF Is Covered by Insurance, High Bills and Hassles Abound

    After years of trying to have a baby without success, Brenna Kaminski and her husband, Joshua Pritt, decided to try in vitro fertilization. Only 15 states require insurance to cover fertility treatments, and Florida, where Kaminski and Pritt live, isn’t one of them. Still, the couple’s insurance, from Pritt’s job at an energy company, did […]

  • California Opens Medicaid to Older Unauthorized Immigrants

    On May 1, California opened Medi-Cal to older immigrants residing in the state without legal permission. Unauthorized immigrants over age 49 who fall below certain income thresholds are now eligible for full coverage by Medi-Cal, California’s version of Medicaid, the federal-state partnership that provides health insurance to low-income people. Unauthorized immigrants of all ages account […]

  • Journalists Cover the Gamut, From Rising Insulin Costs to Delays in Autism Care for Children

    KHN Midwest correspondent Bram Sable-Smith shared a firsthand perspective on ballooning insulin costs on “Tradeoffs” on April 21. Click here to hear Sable-Smith on “Tradeoffs” Read Sable-Smith’s “I Write About America’s Absurd Health Care System. Then I Got Caught Up in It.” KHN’s Colleen DeGuzman profiled the last abortion clinic in the Rio Grande Valley […]

  • Is My Drug Copay Coupon a Form of Charity — Or a Bribe?

    Before my insurer had even preapproved coverage of the new injectable medicine my doctor had prescribed, I got a voicemail from its manufacturer informing me that I might qualify for its copay assistance program. That meant the company would cover at least the lion’s share of my copay, leaving me with a minimal, if any, […]

  • Washington State Retools First-in-the-Nation Long-Term Care Benefit

    Patricia Keys, 71 and a stroke survivor, needs help with many everyday activities, such as dressing and bathing. Her daughter Christina, who lives near her mom in Vancouver, Washington, cares for her in the evenings and pays about $3,000 a month for help from other caregivers. Christina Keys, 53, was thrilled three years ago when […]

  • KHN’s ‘What the Health?’: News You Might Have Missed

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. It’s been extra busy on the health policy beat lately, so a congressional recess provides a chance to explore some of the important stories that people might […]

  • Who Doesn’t Text in 2022? Most State Medicaid Programs

    West Virginia will use the U.S. Postal Service and an online account this summer to connect with Medicaid enrollees about the expected end of the covid public health emergency, which will put many recipients at risk of losing their coverage. What West Virginia won’t do is use a form of communication that’s ubiquitous worldwide: text […]

  • California Handed Its Medicaid Drug Program to One Company. Then Came a Corporate Takeover.

    SACRAMENTO, Calif. — Prescription drug costs for California’s massive Medicaid program were draining the state budget, so in 2019 Gov. Gavin Newsom asked the private sector for help.  The new Medicaid drug program debuted this January, with a private company in charge. But it was woefully unprepared, and thousands of low-income Californians were left without […]

  • KHN’s ‘What the Health?’: Finally, a Fix for the ‘Family Glitch’

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The Biden administration this week moved to fix the so-called family glitch in the Affordable Care Act, which has prevented dependents from getting federal subsidies to buy […]

  • The End of the Covid Emergency Could Mean a Huge Loss of Health Insurance

    If there has been a silver lining to this terrible covid-19 pandemic, it is that the rate of Americans without health insurance dropped to a near-historic low, in response to various federal initiatives connected to the government-declared public health emergency. Now, as the pandemic’s acute phase seemingly draws to an end, millions of low-income and […]

  • KHN’s ‘What the Health?’: Funding for the Next Pandemic

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts. President Joe Biden released his budget proposal for 2023 this week, and it calls for a nearly 27% increase in funding for the Department of Health and […]

  • The Case of the $489,000 Air Ambulance Ride

    Sean Deines and his wife, Rebekah, were road-tripping after he lost his job as a bartender when the pandemic hit. But while visiting his grandfather in a remote part of Wyoming, Sean started to feel very ill. Rebekah insisted he go to an urgent care center in Laramie. “‘Your white blood count is through the […]

  • How to Avoid Surprise Bills — And the Pitfalls in the New Law

    Patients are no longer required to pay for out-of-network care given without their consent when they receive treatment at hospitals covered by their health insurance since a federal law took effect at the start of this year. But the law’s protections against the infuriating, expensive scourge of surprise medical bills may be only as good […]

  • The Demise of Single-Payer in California Trips Up Efforts in Other States

    SACRAMENTO — Single-payer health care didn’t stand a chance in California this year. Even in this deep-blue bastion, Democratic lawmakers shied away from legislation that would have put state government in charge of health care and taxed Californians heavily to do so — a massive transformation that would have forced them to take on the […]

  • Backlogs in California’s Medicaid Drug Program Ease, but Problems Persist

    SACRAMENTO, Calif. — The contractor running California’s new Medicaid prescription drug program has addressed shortfalls that earlier this year left thousands of enrollees without critical medications, some languishing on hold for hours as they sought help, state officials told lawmakers Thursday.  But doctors and health care clinics say that some patients are still suffering and that […]

  • KHN’s ‘What the Health?’: Contemplating a Post-‘Roe’ World

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. With those on both sides of the abortion debate anticipating that the Supreme Court this year will weaken or overturn Roe v. Wade, which established the right […]

  • Other States Keep Watchful Eye on Snags in Washington’s Pioneering Public-Option Plan

    With prospects dim for the U.S. to adopt a single-payer “Medicare for All” program, health care reform advocates turned instead to an insurance plan designed by the government that could compete with private insurance plans sold on the health care exchanges. The idea behind this “public option” is that it could ultimately expand health care […]

  • An $80,000 Tab for Newborns Lays Out a Loophole in the New Law to Curb Surprise Bills

    When Greg and Sugar Bull were ready to start a family, health challenges necessitated that they work with a gestational surrogate. The woman who carried and gave birth to their twins lived two states away. The pregnancy went well until the surrogate experienced high blood pressure and other symptoms of preeclampsia, which could have harmed […]

  • Missouri Takes Months to Process Medicaid Applications — Longer Than Law Allows

    Aneka French applied for Medicaid in October, not long after Missouri became the 38th state to expand eligibility for the program. But her application sat for months in a backlog with tens of thousands of others. While she waited, French, 45, an uninsured medical technician from St. Louis, paid out-of-pocket when she was treated at […]

  • Demand for Service Dogs Unleashes a ‘Wild West’ Market

    Jenni Mahnaz admits she’s not much of a dog person. She’s mildly allergic and the only pet she had as a child was a hermit crab. But once she learned that specially trained dogs could help her daughters with their medical needs, she was willing to do anything to make it happen. Her oldest daughter, […]

  • Health Policy Valentines Too Sweet Not to Tweet

    Nothing brightens our Twitter feeds like a few good health policy valentines ― except maybe a haiku or two. Tweeters showered us with love this season, writing poetic valentines about covid-19 testing and booster shots, the No Surprises Act, and more. Here are some of our favorites, starting with the winning tweet from @AlanJCard. ♡ […]

  • Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead

    The Biden administration and state officials are bracing for a great unwinding: millions of people losing their Medicaid benefits when the pandemic health emergency ends. Some might sign up for different insurance. Many others are bound to get lost in the transition. State Medicaid agencies for months have been preparing for the end of a […]

  • ‘Somebody Is Gonna Die’: Medi-Cal Patients Struggle to Fill Prescriptions

    SACRAMENTO, Calif. — A month into its debut, California’s new Medicaid prescription drug program is riddled with problems, leaving thousands of patients without medications — often after languishing on hold for up to eight hours on call center phone lines. On Jan. 1, the state handed control of its Medicaid drug program, known as Medi-Cal […]

  • Take a Tip from Domino’s

    By KIM BELLARD If you’re already thinking ahead to next Sunday’s Super Bowl, you might be thinking about Domino’s, because, as everyone knows, pizza and football go together like mom and apple pie.  I’m thinking about Domino’s too, but not because I’m planning my order.  It’s about their new program to reward customers who do […]

  • KHN’s ‘What the Health?’: Paging the HHS Secretary

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Health and Human Services Secretary Xavier Becerra is becoming a target for both Democrats and Republicans over what they call a lack of coordination of covid efforts […]

  • Mental Health Therapists Seek Exemption From Part of Law to Ban Surprise Billing

    Groups representing a range of mental health therapists say a new law that protects people from surprise medical bills puts providers in an ethical bind and could discourage some patients from care. The therapists take no issue with the main aim of the legislation, which is to prevent patients from being blindsided by bills, usually […]

  • Matthew’s health care tidbits: #What is insurance again?

    Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt For my health care tidbits this week, I […]

  • Listen: Generous Deals, and a Few Unwanted Surprises, at Covered California

    Can’t see the audio player? Click here to listen. KHN Southern California correspondent Bernard J. Wolfson was on “Línea Abierta,” a Radio Bilingüe weekday news program, answering questions for a Spanish-speaking audience about his recent column on health plan enrollment through California’s Affordable Care Act marketplace, Covered California. Wolfson’s column discusses the extraordinary deals available […]

  • Medicare Patients Win the Right to Appeal Gap in Nursing Home Coverage

    A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands of Medicare beneficiaries without coverage for nursing home care, and no way to challenge a denial. The Jan. 25 ruling, which came in response to a 2011 class-action lawsuit eventually […]

  • KHN’s ‘What the Health?’: Record ACA Enrollment Puts Pressure on Congress

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The Biden administration announced that 14.5 million Americans have signed up for health insurance under the Affordable Care Act for 2022. That’s a record, and several states […]

  • Watch: ER Charged $1,012 for Almost No Care

    “CBS Mornings” host Tony Dokoupil interviewed KHN Editor-in-Chief Elisabeth Rosenthal about January’s Bill of the Month installment, a collaboration with NPR. The Bhatt family of St. Peters, Missouri, was charged $1,012 for an emergency room visit for son Martand. The toddler had burned his hand on a stove days before, and, after it started blistering, […]

  • What the Federal ‘No Surprises Act’ Means in California

    Betty Chow, a Los Angeles resident, had a cervical disc replaced in August 2020 at a surgery center that was part of her Anthem Blue Cross PPO network. Thirteen months later, she was blindsided by a bill for nearly $2,000 from the anesthesiologist who was on her surgical team but was not contracted with her […]

  • ¿Por qué Medicare no paga por las pruebas caseras para COVID?

    ¿Qué grupo es especialmente vulnerable a los estragos de covid, incluso si está vacunado por completo y con sus refuerzos? Los adultos mayores. Sin embargo, ¿quién tendrá más dificultades para obtener pruebas caseras gratuitas para covid según el plan de la administración Biden? Sí, los adultos mayores. Desde el 15 de enero, las personas con […]

  • The Doctor Didn’t Show Up, but the Hospital ER Still Charged $1,012

    Dhaval Bhatt had been warned about hospital emergency rooms. “People always told me to avoid the ER in America unless you are really dying,” said Bhatt, an immigrant from India who got a Ph.D. in pharmacology in the U.S. and is now a research scientist at Washington University in St. Louis. But when Bhatt’s 2-year-old […]

  • Why Medicare Doesn’t Pay for Rapid At-Home Covid Tests

    What group is especially vulnerable to the ravages of covid-19 even if fully vaccinated and boosted? Seniors. And who will have an especially tough time getting free at-home covid tests under the Biden administration’s plan? Yes, seniors. As of Jan. 15, private insurers will cover the cost of eight at-home rapid covid tests each month […]

  • Cinco cosas que deberías saber sobre las pruebas caseras “gratis” para covid

    Los estadounidenses siguen escuchando que es importante hacerse pruebas caseras para covid con frecuencia. El problema es encontrar tests que sean lo suficientemente asequibles para poder comprarlos a menudo. Hacerse pruebas, así como el uso de máscaras, es una medida importante si el país quiere vencer a covid, recuperar las rutinas de la vida diaria […]

  • HHS Proposal for Marketplace Plans Carries a Hefty Dose of Consumer Caution

    Some insurance brokers are enrolling people into Affordable Care Act health plans without their consent, perhaps for the commissions, a move that could put consumers in danger of owing back the subsidies connected with the coverage. The damage could be hundreds or even thousands of dollars. A consumer’s first hint that something is wrong is […]

  • 5 Things You Should Know About ‘Free’ At-Home Covid Tests

    Americans keep hearing that it is important to test frequently for covid-19 at home. But just try to find an “at-home” rapid covid test in a store and at a price that makes frequent tests affordable. Testing, as well as mask-wearing, is an important measure if the country ever hopes to beat covid, restore normal […]

  • KHN’s ‘What the Health?’: Dealing With Drug Prices

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Medicare officials have preliminarily decided to restrict reimbursement for Aduhelm, the controversial Alzheimer’s drug, to only patients participating in approved clinical trials. The FDA approved the drug […]

  • South Dakota Voters to Decide Medicaid Expansion

    South Dakota voters will decide in November whether the state should become the 39th to expand Medicaid under the Affordable Care Act, a move that would provide coverage to 42,000 low-income residents. State officials on Monday officially placed the issue on the ballot after validating thousands of petition signatures. For nearly a decade, the Republican […]

  • With Sexually Transmitted Infections Off the Charts, California Pushes At-Home Tests

    SACRAMENTO, Calif. — California has become the first state to require health insurance plans to cover at-home tests for sexually transmitted infections such as HIV, chlamydia and syphilis — which could help quell the STI epidemic that has raged nearly unchecked as public health departments have focused on covid-19. The rule, part of a broader […]

  • Record Number of Americans Sign Up for ACA Health Insurance

    A record 13.6 million Americans have signed up for health coverage for 2022 on the Affordable Care Act marketplaces, with nearly a month remaining to enroll in most states, the Biden administration announced Wednesday. President Joe Biden’s top health advisers credited the increased government subsidies, which lowered out-of-pocket costs, for the surge in enrollment. They […]

  • An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills

    Owen Loney’s surprise bill resulted from an emergency appendectomy in 2019 at a Richmond, Virginia, hospital. Insurance covered most of the cost of the hospital stay, he said. He didn’t pay much attention to a bill he received from Commonwealth Anesthesia Associates and expected his insurance to cover it. A few months ago, he got […]

  • KHN’s ‘What the Health?’: Manchin Blows Up Biden’s ‘Build Back Better’

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Sen. Joe Manchin (D-W.Va.) dashed the hopes of President Joe Biden and congressional Democrats for passage of the giant “Build Back Better” bill before the end of […]

  • New Parents Slapped With Surprise Bills for Treating Newborns

    After Christine Malik gave birth to her first daughter three years ago, a clinician affiliated with a company called Pediatrix entered the hospital room and fitted the infant with sensors and wires for a hearing test. The child failed the screening required by law for all newborns, the tester said, requiring a follow-up exam. “We […]

  • Layers of Subcontracted Services Confuse and Frustrate Medi-Cal Patients

    Theresa Grant, a resident of Culver City, California, has endured debilitating pain for the past year from a mysterious bulge protruding from her lower rib cage. She takes multiple painkillers every day. And the cause of her agony remains undiagnosed because, despite her tenacious efforts, she hasn’t been able to get a referral to a […]

  • Insurers paid out $2B in rebates for last year’s claims

    Insurers that didn’t meet medical loss ratio requirements have paid out a total of $2 billion in rebates to nearly 10 million people, split between people who received their insurance through individual market plans and group plans. 

  • NICU Bill Installment Plan: That’ll Be $45,843 a Month for 12 Months, Please

    Close to midnight on Nov. 12, 2020, Bisi Bennett was sitting on the couch in her pajamas and feeling uncomfortable. She was about seven months pregnant with her first child, Dorian, and the thought that she could be in labor didn’t even cross her mind. Then, she felt a contraction so strong it knocked her […]

  • ‘An Arm and a Leg’: She Fights Health Insurers for Fun — And Wins

    Can’t see the audio player? Click here to listen. Click here for a transcript of the episode. Health insurance is like some medieval horror, law professor Jackie Fox says.  But, funny thing: She also says insurance fights are easy. For her. She’s been helping people win them for 30 years. For Fox, it started when an […]

  • Post-Pandemic, What’s a Phone Call From Your Physician Worth?

    Maybe this has happened to you recently: Your doctor telephoned to check in with you, chatting for 11 to 20 minutes, perhaps answering a question you contacted her office with, or asking how you’re responding to a medication change. For that, your doctor got paid about $27 if you are on Medicare — maybe a […]

  • A Tale of Two Medicaid Expansions: Oklahoma Jumps In, While Missouri Lags

    Temp worker James Dickerson applied for Medicaid because it will be cheaper than his current health plan. Home health aide Sharon Coleman looks forward to having coverage that will cover a hospital stay. Incoming medical student Danielle Gaddis no longer worries a trip to the doctor will leave her in debt. All three are among […]

  • ‘An Arm and a Leg’: How to Avoid the Worst Health Insurance

    Can’t see the audio player? Click here to listen. Click here for a transcript of the episode. This episode kicks off with a wild ride: How one journalist nearly got roped into a scam. While hunting for a new health insurance plan, award-winning journalist Mitra Kaboli got an offer that seemed too good to be true — and […]

  • ‘An Arm and a Leg’: The Insurance Warrior’s Battle Plan

    Can’t see the audio player? Click here to listen. Click here for a transcript of the episode. Matthew Lientz was an engineer for Boeing for over 30 years. When he was diagnosed with a rare form of cancer, he needed surgery from an expert doctor in another state. Although the surgery was his only option, his […]

  • Patients Get Stranded Out of Network as Insurer-Hospital Contract Talks Fall Apart

    In September, when Shelly Azzopardi went to Wellstar Kennestone Hospital with abdominal pain, she didn’t worry about her insurance. Doctors said she had a case of appendicitis. But she also tested positive at the hospital in Marietta, Georgia, for covid-19. Physicians decided not to do surgery and treated her with antibiotics and painkillers. Azzopardi, 47, […]

  • Missouri’s Thin Dental Safety Net Stretched Amid Medicaid Expansion

    At the Access Family Care clinics in southwestern Missouri, the next available nonemergency dental appointment is next summer. Northwest Health Services, headquartered in St. Joseph, is booked through May. The wait is a little shorter at CareSTL Health in St. Louis — around six weeks. Roughly 275,000 Missourians are newly eligible this year for Medicaid, […]

  • Your Out-of-Pocket Health Care Costs Need Not Be a Mystery

    If you’ve ever had a serious illness or cared for someone who has, you know how quickly the medical bills can pile up: from labs, radiology clinics, pharmacies, doctors, different departments within the same hospital — some of them in your insurance network, others not. It can be extremely confusing, no matter how clever you […]

  • La inscripción de Medicare es temporada abierta para estafadores

    Encontrar el mejor plan médico privado, o de medicamentos, de Medicare entre docenas de opciones es lo suficientemente difícil sin incluir estrategias de venta engañosas. Sin embargo, funcionarios federales dicen que están aumentando las quejas de personas mayores engañadas para que compren pólizas sin su consentimiento, o atraídas por información cuestionable, que pueden no cubrir […]

  • KHN’s ‘What the Health?’: Why Health Care Is So Expensive, Chapter $22K

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Congress appears to be making progress on its huge social spending bill, but even if it passes the House as planned the week of Nov. 15, it’s […]

  • Researcher: Medicare Advantage Plans Costing Billions More Than They Should

    Switching seniors to Medicare Advantage plans has cost taxpayers tens of billions of dollars more than keeping them in original Medicare, a cost that has exploded since 2018 and is likely to rise even higher, new research has found. Richard Kronick, a former federal health policy researcher and a professor at the University of California-San […]

  • Medicare’s Open Enrollment Is Open Season for Scammers

    Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. Yet federal officials say complaints are rising from seniors tricked into buying policies — without their consent or lured by questionable information — that may not cover their drugs or […]

  • As Workers Struggle With Pandemic’s Impact, Employers Expand Mental Health Benefits

    As the covid-19 pandemic burns through its second year, the path forward for American workers remains unsettled, with many continuing to work from home while policies for maintaining a safe workplace evolve. In its 2021 Employer Health Benefits Survey, released Wednesday, KFF found that many employers have ramped up mental health and other benefits to […]

  • Medicare Enrollment Blitz Doesn’t Include Options to Move Into Medigap

    Medicare’s annual open-enrollment season is here and millions of beneficiaries — prompted by a massive advertising campaign and aided by a detailed federal website — will choose a private Medicare Advantage plan. But those who have instead opted for traditional Medicare face a critical decision about private insurance. Too often the import of that choice […]

  • New Health Plans Offer Twists on Existing Options, With a Dose of ‘Buyer Beware’

    Trendy-looking websites promise convenience and freedom from networks, at far less than the cost of traditional health insurance. “Welcome to insurance that’s finally fair,” says one, in bold lettering. “Take care of your health with one easy app,” says another. It’s all part of shopping for health coverage in 2021. While they’re still niche products, […]

  • California Law Aims to Strengthen Access to Mental Health Services

    The number of people with symptoms of depression and anxiety has nearly quadrupled during the covid pandemic, which has made it even more maddeningly difficult to get timely mental health care, even if you have good insurance. A California law signed Oct. 8 by Gov. Gavin Newsom could help. It requires that mental health and […]

  • What’s Scarier Than Covid? Halloween Health Haikus

    Boo that we couldn’t treat all the readers participating in our third annual KHN Halloween Haiku Contest to their moment of gory glory. Your entries — like our health care system — ranged from frighteningly complex to haunting. And, based on a review by our panel of never-say-die judges, here’s the winner and a sampling […]

  • Medicare Punishes 2,499 Hospitals for High Readmissions

    The federal government’s effort to penalize hospitals for excessive patient readmissions is ending its first decade with Medicare cutting payments to nearly half the nation’s hospitals. In its 10th annual round of penalties, Medicare is reducing its payments to 2,499 hospitals, or 47% of all facilities. The average penalty is a 0.64% reduction in payment […]

  • How Billing Turns a Routine Birth Into a High-Cost Emergency

    Caitlin Wells Salerno knew that some mammals — like the golden-mantled ground squirrels she studies in the Rocky Mountains — invest an insane amount of resources in their young. That didn’t prepare her for the resources the conservation biologist would owe after the birth of her second son. Wells Salerno went into labor on the […]

  • Direct Primary Care, With a Touch of Robin Hood

    MODESTO, Calif. — Britta Foster and Minerva Tiznado are in different leagues as far as health care is concerned. Foster, who married into the family that owns the $2.5 billion Foster Farms chicken company, has Blue Shield coverage as well as a high-octane primary care plan that gives her 24/7 digital access to her doctor […]

  • KHN’s ‘What the Health?’: Dems Agree to Agree, But Not on What to Agree On

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Negotiations over what to include in — and cut from — the domestic spending package on Capitol Hill are reportedly making progress, but so far all Democrats […]

  • How to Crush Medical Debt: 5 Tips for Using Hospital Charity Care

    What if a law passed but no one enforced it? That’s essentially what has happened with one small but helpful rule about hospitals and financial assistance for medical bills. The Affordable Care Act, the health law also known as Obamacare, requires nonprofit hospitals to make financial assistance available to low-income patients and post those policies […]

  • Schedule Online Visits First? It’s the Next Big Thing in Health Insurance

    At the height of the covid-19 pandemic, people often relied on telemedicine for doctor visits. Now, insurers are betting that some patients liked it enough to embrace new types of health coverage that encourages video visits — or outright insists on them. Priority Health in Michigan, for example, offers coverage requiring online visits first for […]

  • Health Industry Wields Power in California’s High-Stakes Battle to Lower Health Care Costs

    SACRAMENTO — Gavin Newsom put California’s health care industry on notice when he was a candidate for governor, vowing in 2018 to go after the insurance companies, doctors and hospitals that leave many Californians struggling with enormous medical bills and rising insurance premiums. He pledged to lead California’s single-payer movement, a high-stakes liberal dream that […]

  • Major Insurers Running Billions of Dollars Behind on Payments to Hospitals and Doctors

    Anthem Blue Cross, the country’s second-biggest health insurance company, is behind on billions of dollars in payments owed to hospitals and doctors because of onerous new reimbursement rules, computer problems and mishandled claims, say hospital officials in multiple states. Anthem, like other big insurers, is using the covid-19 crisis as cover to institute “egregious” policies […]

  • The Pandemic Forced My Transgender Wife to Fight Our Insurer Over Hormones

    GUNNISON, Colo. — For the past eight years, my wife, Ky Hamilton, has undergone gender-affirming hormone therapy. As a transgender woman, she injects Depo-Estradiol liquid estrogen into her thigh once a week. This drug has allowed her to physically transition as a woman, and each vial, which lasts around five weeks, was completely covered by […]

  • Journalists Drill Down on Covid Vaccine Boosters, Misinformation Online

    KHN Midwest correspondent Lauren Weber discussed how hospitals are dealing with covid-19 on WOSU’s “All Sides With Ann Fisher” on Tuesday. Weber also discussed the Food and Drug Administration’s approval of a covid vaccine booster on WAMU’s “1A” on Sept. 24. Click here to hear Weber on WOSU Read Weber’s “Covid Is Killing Rural Americans […]

  • ¿Un test de covid más caro que un Tesla? En Texas es posible

    Cuando covid-19 golpeó el año pasado, la compañía de Travis Warner se puso más ocupada que nunca. Instala sistemas de video e Internet, y con la gente repentinamente trabajando desde casa, las llamadas solicitando servicios aumentaron. Warner y sus empleados tomaron precauciones como usar máscaras y distanciarse físicamente, pero ir a las casas de los […]

  • As Democrats Bicker Over Massive Spending Plan, Here’s What’s at Stake for Medicaid

    Hours after the Supreme Court in 2012 narrowly upheld the Affordable Care Act but rejected making Medicaid expansion mandatory for states, Obama administration officials laughed when asked whether that would pose a problem. In a White House briefing, top advisers to President Barack Obama told reporters states would be foolish to turn away billions in […]

  • A Covid Test Costing More Than a Tesla? It Happened in Texas.

    When covid-19 struck last year, Travis Warner’s company became busier than ever. He installs internet and video systems, and with people suddenly working from home, service calls surged. He and his employees took precautions like wearing masks and physically distancing, but visiting clients’ homes daily meant a high risk of covid exposure. “It was just […]

  • Death in Dallas: One Family’s Experience in the Medicaid Gap

    For years, Millicent McKinnon of Dallas went without health insurance. She was one of roughly 1 million Texans who earn too much to qualify for Medicaid in the state but too little to buy their own insurance. That is, until she died in 2019. She was 64 and had been unable to find consistent care […]

  • ‘An Arm and a Leg’: They Turned Grief Into Action

    Can’t see the audio player? Click here to listen. In 2004, 24-year-old Manny Lanza urgently needed surgery for a life-threatening brain condition. But he didn’t have insurance, so his hospital refused to schedule the treatment — until it was too late. Manny died waiting.  In the months that followed, Manny’s parents, Reynaldo Prieto and Levia Lanza, […]

  • Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans

    Nevada dentist David White has seen diseased and rotted teeth in the mouths of patients who routinely put off checkups and avoided minor procedures such as fillings. While dental phobia is a factor, White said, the overriding reason people avoid treatment is cost. To help patients lacking dental insurance, White in 2019 started offering a […]

  • Leader of California’s Muscular Obamacare Exchange to Step Down

    Peter Lee, who has steered California’s Affordable Care Act marketplace since late 2011 and helped mold it into a model of what the federal health care law could achieve, announced Thursday he will leave his post in March. As executive director of Covered California, Lee has worked closely with the administrations of Democratic presidents Barack […]

  • KHN’s ‘What the Health?’: Much Ado About Drug Prices

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Congressional Democrats are finding it harder to actually write legislation to lower drug prices than it is to make promises about it. But the drug price provisions of the $3.5 trillion social-spending bill […]

  • Health Care Unions Defending Newsom From Recall Will Want Single-Payer Payback

    SACRAMENTO, Calif. — Should Gavin Newsom survive the Republican-driven attempt to oust him from office, the Democratic governor will face the prospect of paying back supporters who coalesced behind him. And the leaders of California’s single-payer movement will want their due. Publicly, union leaders say they’re standing beside Newsom because he has displayed political courage […]

  • Georgia Eyes New Medicaid Contract. But How Is the State Managing Managed Care?

    Just before Frank Berry left his job as head of Georgia’s Medicaid agency this summer, he said the state “will be looking for the best bang for the buck” in its upcoming contract with private insurers to cover the state’s most vulnerable. But whether the state — and Medicaid patients — are getting an optimal […]

  • Watch: Same Providers, Similar Surgeries, But Different Bills

    Ely Bair had similar surgeries, at the same hospital, with the same insurer. But he received very different big medical bills. KHN Editor-in-Chief Elisabeth Rosenthal joins “CBS This Morning” to break down how this could happen to you and what you can do to avoid it.  KHN (Kaiser Health News) is a national newsroom that […]

  • CMS to fund 60 ACA navigator orgs next year

    CMS will provide $80 million to 60 organizations that train ACA navigators — who help consumers find coverage on the federally funded marketplaces — in the 2022 plan year, up from 30 organizations that received $10 million this year.

  • Beneficiarios de Medicaid se vacunan mucho menos contra covid

    Los beneficiarios de Medicaid se están vacunando contra covid-19 a tasas mucho más bajas que la población general, mientras los estados buscan las mejores estrategias para mejorar el acceso a las vacunas, y persuadir a quienes siguen indecisos. Los esfuerzos de las agencias estatales de Medicaid y los planes de salud privados que la mayoría […]

  • Jaw Surgery Takes a $27,119 Bite out of One Man’s Budget

    For years, Ely Bair dealt with migraine headaches, jaw pain and high blood pressure, until a dentist recommended surgery to realign his jaw to get to the root of his health problems. The fix would involve two surgeries over a couple of years and wearing braces on his teeth before and in between the procedures. […]

  • Headed Away to School? Here’s What Students With Health Issues Need to Know

    College is a time of transition, but for those managing chronic medical conditions, it may also be the first time they will be wholly responsible for their own health: setting appointments, securing supplies and pharmaceuticals, and monitoring symptoms. For those heading to schools far from home, it can be especially tricky navigating the complex world […]

  • Readers and Tweeters Ponder Vaccines and Points of Fairness

    Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. Higher Insurance Rates for the Unvaccinated? Snuff Out That Idea This is about Dr. Elisabeth Rosenthal’s comments on “All In With Chris Hayes” (“Analysis: Don’t Want a Vaccine? Be Prepared to […]

  • Why Doesn’t Medicare Cover Services So Many Seniors Need?

    Sorry, Joe Namath. Despite what you keep saying in those TV ads, under Medicare, seniors are not “entitled to eliminate copays and get dental care, dentures, eyeglasses, prescription drug coverage, in-home aides, unlimited transportation and home-delivered meals, all at no additional cost.” But if Democratic lawmakers in Congress have their say, seniors could soon be […]

  • Análisis: ¿No quieres una vacuna? Prepárate para pagar más por tu seguro de salud

    La tasa de vacunación contra covid-19 en Estados Unidos es de alrededor del 60% desde los 12 años en adelante. Esto no es suficiente para alcanzar la llamada inmunidad colectiva, y en estados como Missouri, donde varios condados tienen tasas de vacunación inferiores al 25%, los hospitales están abrumados por brotes graves de la variante […]

  • Analysis: Don’t Want a Vaccine? Be Prepared to Pay More for Insurance.

    America’s covid-19 vaccination rate is around 60% for ages 12 and up. That’s not enough to reach so-called herd immunity, and in states like Missouri — where a number of counties have vaccination rates under 25% — hospitals are overwhelmed by serious outbreaks of the more contagious delta variant. The vaccine resisters offer all kinds of reasons for refusing the free […]

  • Watch: Cyclist Hits Olympic-Size Medical Bills After Crash

    “CBS This Morning,” in partnership with KHN and NPR, interviews Phil Gaimon, a cyclist who had hoped to be in Tokyo next week as a competitor in the track events on the USA Cycling national team. Instead, a crash on the velodrome track in Pennsylvania in 2019 ended his Olympic dream and left him with […]

  • Diabetes Drug’s New Weight Loss Formula Fuels Cost-Benefit Debate

    The long list of side effects that follow ads for the newer expensive drugs to treat Type 2 diabetes sometimes include an unusual warning: They might cause weight loss. That side effect is one that many people — especially those with Type 2 diabetes, which is associated with obesity — may desperately want. So it’s […]

  • Olympic Dream Dashed After Bike Crash and Nightmare Medical Bill Over $200K

    It was a race in Pennsylvania that could have sent cyclist Phil Gaimon to the Tokyo Olympics; instead, a serious crash landed the Californian in two hospitals on the East Coast. Gaimon knows accidents are, unfortunately, part of the sport. He had retired from competitive road cycling three years earlier, but a recruiting call came […]

  • Sign-Up Window for Free COBRA Coverage for Many Laid-Off Workers Closes This Week

    After being laid off from her job as a systems analyst for a specialty chemicals company in December, Gabriela de Pompignan opted to hang on to her former employer’s insurance coverage under the federal law known as COBRA. Typically, laid-off workers pick up the total cost of premiums under COBRA, but her company paid roughly […]

  • Bye-Bye to Health Insurance ‘Birthday Rule’? Kansas Lawmaker Floats Fix

    When Kayla Kjelshus gave birth to her first child, the infant spent seven days in the neonatal intensive care unit, known as the NICU. This stressful medical experience was followed by an equally stressful financial one. Because of an obscure health insurance policy called the “birthday rule,” Kjelshus and her husband, Mikkel, were hit with […]

  • Contraception Is Free to Women, Except When It’s Not

    For Stephanie Force, finding a birth control method that she likes and can get without paying out-of-pocket has been a struggle, despite the Affordable Care Act’s promise of free contraceptives for women and adolescent girls in most health plans. The 27-year-old physician recruiter in Roanoke, Virginia, was perfectly happy with the NuvaRing, a flexible vaginal […]

  • Readers and Tweeters Connect the Dots on Topics From Vaccine Development to Long Covid

    Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. A Concerned Taxpayer Takes Stock of Vaccine Efforts Your recent article “Novavax’s Effort to Vaccinate the World, From Zero to Not Quite Warp Speed” (July 19) seems to reveal Maryland-based Novavax […]

  • Sen. Wyden: $3.5T Budget May Have to Trim but It Can Set a Path to ‘Ambitious Goals’

    Exactly what American health care will look like if Democrats can pass their $3.5 trillion spending plan is unclear, but the senator negotiating its health-related provisions hopes what emerges will be dramatic: the first complete health care system for older Americans and significantly reduced costs for everyone else. “We are setting very, very ambitious goals,” […]

  • KHN’s ‘What the Health?’: Here Comes Reconciliation

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The expansion of health benefits is a major piece of the tentative budget deal reached this week by Democrats in Congress. They plan to press ahead — […]

  • KHN’s ‘What the Health?’: Un-Trumping the ACA

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The Biden administration this week proposed a series of changes aimed at boosting insurance enrollment under the Affordable Care Act, undoing changes made by the Trump administration […]

  • States Step Up Push to Regulate Pharmacy Drug Brokers

    Under pressure to rein in skyrocketing prescription drug costs, states are targeting companies that serve as conduits for drug manufacturers, health insurers and pharmacies. More than 100 separate bills regulating those companies, known as pharmacy benefit managers, have been introduced in 42 states this year, according to the National Academy for State Health Policy, which […]

  • Children and Covid: Journalists Explore Grief and Vaccine Side Effects

    KHN senior correspondent JoNel Aleccia discussed grief among the estimated 46,000 children in the U.S. who lost a parent to covid-19 on NBC News NOW on Tuesday. Click here to watch Aleccia on NBC News NOW Read Aleccia’s “Thousands of Young Children Lost Parents to Covid. Where’s Help for Them?“ KHN senior correspondent Sarah Varney […]

  • KHN’s ‘What the Health?’: The ACA Lives

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. For the third time in nine years, the Affordable Care Act has survived a constitutional challenge at the Supreme Court. In a 7-2 decision, the court ruled […]

  • Pandemia eleva el número de beneficiarios de Medicaid a más de 80 millones

    Las últimas cifras de inscripción al Medicaid muestran que creció de 71,3 millones de miembros en febrero de 2020, cuando la pandemia comenzaba en los Estados Unidos, a 80,5 millones en enero, según un análisis de KFF de datos federales. La recesión causada por la pandemia y un requisito federal de que los estados mantuvieran […]

  • Pandemic Swells Medicaid Enrollment to Record 80 Million People

    The pandemic-caused recession and a federal requirement that states keep Medicaid beneficiaries enrolled until the national emergency ends swelled the pool of people in the program by more than 9 million over the past year, according to a report released Thursday. The latest figures show Medicaid enrollment grew from 71.3 million in February 2020, when […]

  • ‘An Arm and a Leg’: When Your Insurance Company Says No, How to Ask for a Yes

    Can’t see the audio player? Click here to listen. Jeannine Cain started her career dealing with insurance companies for various medical offices. Later she worked for Blue Cross Blue Shield, and now she is a health care data consultant. She really knows how things operate behind the scenes. When her son got a jumbo-size medical bill, […]

  • Colorado Bill Aims to Give Farmworkers Easier Access to Medical Care

    SAN LUIS VALLEY, Colo. — A woman with pregnancy complications needed permission from her boss to visit a doctor. Community health volunteers were turned away from delivering food and covid information to worker housing. A farmworker had a serious allergic reaction but was afraid to seek treatment. To Nicole Civita, policy director with Colorado advocacy […]

  • New Montana Laws Enshrine Health Care Alternatives, for Better or Worse

    When Paul Rana’s primary care physician left the VA clinic in Kalispell to open her own practice, he followed her. But instead of picking up a new health insurance policy, Rana and his partner agreed to pay a monthly fee that came with the promise of better access. Their provider, Dr. Lexi Tabor-Manaker, opened Glacier […]

  • Can a Subscription Model Fix Primary Care in the US?

    In April, San Francisco-based primary care company One Medical revealed an eye-popping compensation package for its chief executive and chairman, Amir Dan Rubin. His $199 million payday, particularly noteworthy at a company that has yet to turn a profit, made Rubin the second-highest-paid CEO in the United States last year — but only on paper. […]

  • Expanding Insurance Coverage Is Top Priority for New Medicare-Medicaid Chief

    The new head of the federal agency that oversees health benefits for nearly 150 million Americans and $1 trillion in federal spending said in one of her first interviews that her top priorities will be broadening insurance coverage and ensuring health equity. Use Our Content It can be republished for free. “We’ve seen through the […]

  • Survey: 60% of Americans support Medicare expansion strategies

    A majority of the general public is in support of expanding Medicare — either by opening it up to all Americans or lowering the eligibility age, according to new survey results. But among current Medicare enrollees, nearly half want the program to stay as it is.

  • Caring for an Aging Nation

    USE OUR CONTENT This story can republished for free. Please contact for embed codes. Table of Contents A Variety of Services Booming Number of Seniors The Cost of Long-Term Care Services The Physical – and Financial – Burden The $61 Billion Price Tag Health care for the nation’s seniors looms large as the baby-boom […]

  • Suficiente para arruinar el descanso: le cobran $10,322 por un estudio del sueño

    Los ronquidos de José Mendoza eran malos, pero para su esposa Nancy era peor cuando dejaba de respirar. El repentino silencio la despertaba, y si pasaban demasiados segundos, lo zarandeaba para que comenzara a respirar de nuevo. Esto sucedía varias veces a la semana. Diagnosticado con apnea del sueño severa hace 15 años, a Mendoza […]

  • Enough to Wreck Their Rest: $10,322 for a Sleep Study

    José Mendoza’s snoring was bad — but the silence when he stopped breathing was even worse for his wife, Nancy. The sudden quiet would wake her and she waited anxiously for him to take another breath. If too many seconds ticked by, she pushed him hard so that he moved and started breathing again. This […]

  • Why Your Dentist Might Seem Pushy

    In 1993, Dr. David Silber, a dentist now practicing in Plano, Texas, was fired from the first dental clinic he worked for. He’d been assigned to a patient another dentist had scheduled for a crown preparation — a metal or porcelain cap for a broken or decayed tooth. However, Silber found nothing wrong with the […]

  • KHN’s ‘What the Health?’: Drug Price Effort Hits a Snag

    Can’t see the audio player? Click here to listen on SoundCloud. The high cost of prescription drugs is a top health issue for the public and politicians, but concerns raised by a group of moderate Democrats threaten to derail a bill being pushed by House Democratic leaders. Meanwhile, the Food and Drug Administration has authorized the […]

  • You’ve Added Your Kids to Your Health Plan. What About Mom?

    SACRAMENTO — When Laura Chavez’s 74-year-old mom needed eye surgery last month, Chavez paid cash for the procedure. This story also ran on Los Angeles Times. It can be republished for free. The cost? $15,000 — and that was for just one eye. She couldn’t afford both. Her mom, Esperanza Chavez, doesn’t qualify for Medicare […]

  • From Covid Coverage to ‘Public Option’ Plans, Journalists Delve Into Details

    KHN senior correspondent Julie Appleby discussed changes in insurance coverage for covid-19 care on Newsy on Thursday. Click here to watch Appleby on Newsy Read Appleby’s “Time to Say Goodbye to Some Insurers’ Waivers for Covid Treatment Fees” KHN senior correspondent Mary Agnes Carey discussed Connecticut’s legislative efforts to pass a “public option” insurance plan […]

  • Survey: 42% of Americans may not go back to in-person care this year

    Despite the ongoing Covid-19 vaccine rollout, a significant percentage of Americans say they are planning to delay care in 2021 or are unsure about in-person care, a new survey shows. Virtual visit options, insurance coverage and clear information on Covid-19 safety protocols are some of the factors that will drive provider selection this year.

  • Hit by Higher Prices for Gear, Doctors and Dentists Want Insurers to Pay

    SACRAMENTO — Treating patients has become more expensive during the pandemic, and doctors and dentists don’t want to be on the hook for all the new costs. This story also ran on Los Angeles Times. It can be republished for free. For instance, the box of 100 gloves that cost $2.39 in February 2020 costs […]

  • Covered California Says Health Insurance Just Got Too Cheap to Ignore

    If you are uninsured because health coverage seemed too expensive the last time you looked, it’s time to look again. Use Our Content It can be republished for free. A new federal law could make it a whole lot cheaper to buy your own insurance if you don’t get coverage through an employer or a […]

  • What a Difference a Year Makes in Colorado’s Case for a Public Option Plan

    DENVER — Before the pandemic, Colorado looked set to become the second state to pass what’s known as a “public option” health insurance plan, which would have forced hospitals that lawmakers said were raking in obscene profits to accept lower payments. But when covid-19 struck, legislators hit pause. Use Our Content It can be republished […]

  • Watch: What Happens When Car and Health Insurance Collide

    “CBS This Morning,” in collaboration with KHN and NPR, tells the story of Mark Gottlieb, a marketing consultant in Little Ferry, New Jersey, who faced more than $700,000 in medical bills after surgery on his spine. Gottlieb was injured in a car accident, and, despite having the maximum amount of personal injury protection in his […]

  • Time to Say Goodbye to Some Insurers’ Waivers for Covid Treatment Fees

    Just as other industries are rolling back some consumer-friendly changes made early in the pandemic — think empty middle seats on airplanes — so, too, are health insurers. Many voluntarily waived  all deductibles, copayments and other costs for insured patients who fell ill with covid-19 and needed hospital care, doctor visits, medications or other treatment. […]

  • After Accident, Patient Crashes Into $700,000 Bill for Spine Surgery

    Mark Gottlieb’s life changed in an instant when another driver crashed into his car, damaging four vertebrae in his upper spine and smashing six teeth. In the months following that January 2019 crash, Gottlieb got the teeth crowned and, for debilitating neck pain, tried injections, chiropractic care and physical therapy. The treatments were all covered […]

  • Strides Against HIV/AIDS Falter, Especially in the South, as Nation Battles Covid

    Facing a yearlong siege from the coronavirus, the defenses in another, older war are faltering. This story also ran on NPR. It can be republished for free. For the last two decades, HIV/AIDS has been held at bay by potent antiviral drugs, aggressive testing and inventive public education campaigns. But the COVID-19 pandemic has caused […]

  • ‘Explained by KHN’: Health Insurance Help in Covid Relief Law

    The twists and turns of the American health system can sometimes leave people lost, confused and looking for answers. We’ve created a new video series — “Explained by KHN” — in which our correspondents and editors answer common health care and health policy questions.  The $1.9 trillion covid relief package that President Joe Biden signed […]

  • Bright Health acquires Zipnosis, enters telehealth market

    Insurance technology startup Bright Health has purchased Zipnosis, which provides telehealth services. Though details of the new transaction are sparse, the acquisition aims to lower healthcare costs and expand access to quality care.

  • Report: Bright Health eyes $1B IPO

    Insurance startup Bright Health is reportedly planning to raise up to $1 billion in an IPO that will be launched in the second quarter of 2021. The company, which provides several insurance products as well as an IT platform, could be valued at more than $10 billion, Bloomberg reported.

  • KHN’s ‘What the Health?’: Planning for Round Two

    Can’t see the audio player? Click here to listen on SoundCloud. Congress is out of session, but that hasn’t stopped Democrats from planning their next round of health legislation. Together with President Joe Biden, they are looking at a broad array of possibilities, from allowing Medicare to negotiate drug prices to adding more benefits to the […]

  • Indiana’s Medicaid Expansion — Designed by Pence and Verma — Panned in Federal Report

    Indiana’s Medicaid expansion — with its “personal responsibility” provisions that require enrollees to pay monthly premiums and manage health savings accounts — proved no better at improving health and access to care than other state expansions, a federally commissioned study found. Use Our Content It can be republished for free. Even when compared with states […]

  • In California, Blue Shield’s Vaccination Takeover Fixes What Wasn’t Broken

    In California’s Mendocino County, public health officials and community clinics say they have hit their vaccination stride. This story also ran on The Mendocino Beacon. It can be republished for free. Despite the county’s remoteness and its largely rural population spread among wooded mountains, rugged coastline and idyllic vineyards, about 40% of eligible adults have […]

  • Journalists Dish on Vaccination Loopholes and Alliances

    Reporter Fred Mogul discussed how college students are using loopholes to get vaccinated for travel with Newsy on Thursday. Click here to watch Mogul on Newsy Read Mogul’s “Some Dream — Others Scheme — To Find a Vaccine Before Spring Break” California politics correspondent Samantha Young discussed the relationship between Gov. Gavin Newsom and Blue […]

  • The Great Undoing: Which of Trump’s Policies Will Biden Reverse?

    KHN has put together an interactive tool of significant health policies implemented by the Trump administration using its own authority — executive orders, agency guidance or formal regulations — and is tracking Biden administration and court actions. We will update this chart as actions are taken. Topics: Affordable Care Act | HHS Operations | Immigration […]

  • KHN’s ‘What the Health?’: Getting Down to Work at HHS

    Can’t see the audio player? Click here to listen on SoundCloud. As questions swirl about the covid vaccine made by AstraZeneca, public health experts are worried the confusion could create more doubts among people already hesitant to get a vaccine. Meanwhile, the first Senate-confirmed officials are settling into their offices at the Department of Health and […]

  • Democrats Gave Americans a Big Boost Buying Health Insurance. It Didn’t Come Cheap.

    When Democrats pushed through a two-year expansion of the Affordable Care Act in the covid-relief bill this month, many people celebrated the part that will make health insurance more affordable for more Americans. This story also ran on NPR. It can be republished for free. But health care researchers consider this move a short-term fix […]

  • Lots of Health Insurance Help in Covid Relief Law — But Do Your Homework First

    There’s something for everyone with private health insurance in the American Rescue Plan Act, but determining the best way to benefit may be confusing. This story also ran on NBC News. It can be republished for free. The $1.9 trillion covid relief law that President Joe Biden signed this month will make coverage significantly more […]

  • Under New Cost-Cutting Medicare Rule, Same Surgery, Same Place, Different Bill

    A cost-saving change in Medicare launched in the final days of the Trump administration will cut payments to hospitals for some surgical procedures while potentially raising costs and confusion for patients. This story also ran on The Washington Post. It can be republished for free. For years, the Centers for Medicare & Medicaid Services classified […]

  • Journalists Analyze the Covid Relief Bill

    Reporter LJ Dawson discussed how undocumented immigrants have been left out of the pandemic relief package with Newsy on Tuesday. Click here to watch Dawson on Newsy Read Dawson’s “Without a Pandemic Safety Net, Immigrants Living Illegally in US Fall Through the Cracks“ KHN correspondent Emmarie Huetteman discussed Affordable Care Act provisions included in the […]

  • Covid-Inspired Montana Health Insurance Proposal Wouldn’t Kick In for 2 Years

    [UPDATED at 1 p.m. ET] For employees of small businesses in Montana suddenly laid off during the covid-19 pandemic, maintaining health insurance coverage could be a struggle. This story also ran on Fortune. It can be republished for free. Employers with 20 or more workers offer a bridge insurance program made possible by a federal […]

  • KHN’s ‘What the Health?’: ACA Packs More Benefits — And More Confusion

    Can’t see the audio player? Click here to listen on SoundCloud. The covid relief bill signed by President Joe Biden a week ago includes billions of dollars in new health benefits for consumers. But those benefits may be hard for people to take advantage of because of the interaction with the income tax system and the […]

  • Analysis: The Trump Health Care Policies That Deserve to Stick Around

    President Joe Biden’s goal of providing health care for more Americans advanced this week with his signing of an economic stimulus package that includes subsidies for health insurance premiums and new incentives for states to expand Medicaid, as well as the potential confirmation of Xavier Becerra as secretary of Health and Human Services. This story […]

  • The Boom in Out-of-State Telehealth Threatens In-State Providers

    HELENA, Mont. — When the Hazelden Betty Ford Foundation began offering telehealth services in Montana in early February, the nation’s largest nonprofit addiction treatment provider promised quality care for far-flung residents without their even having to leave home. This story also ran on Fortune. It can be republished for free. That promise was what Montana […]

  • Pandemic Aid Package Includes Relief From High Premiums

    This story also ran on NPR. It can be republished for free. As President Joe Biden’s pandemic relief package steams through Congress, Democrats have hitched a ride for a top health care priority: strengthening the Affordable Care Act with some of the most significant changes to insurance affordability in more than a decade. The bill […]

  • Readers and Tweeters Dispense Timely Advice for Difficult Times

    Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names. How to Explain Vaccines to People Who Resist Them Here is an attempt to write something that might convince people who resist getting vaccinations (“Vaccine Hesitancy vs. Vaccine Refusal: Nursing Home […]

  • KHN’s ‘What the Health?’: Staffing Up at HHS

    Can’t see the audio player? Click here to listen on SoundCloud. More than a month into President Joe Biden’s term, nominees to fill some of the top posts at the Department of Health and Human Services are finally getting confirmation hearings in the Senate, starting with the nominee for secretary, California Attorney General Xavier Becerra. Barring […]

  • New California Law Makes It Easier to Get Care for Mental Health and Substance Abuse

    USE OUR CONTENT It can be republished for free. Karen Bailey’s 20-year-old daughter has struggled with depression and anxiety for years. Since 2017, she’s been in three intensive group therapy programs and, each time, the family’s insurer cut her coverage short, says Bailey. “At a certain point, they would send us a form letter saying: […]

  • Oscar Health looks to raise $1B in IPO

    Insurance startup Oscar Health plans to price its IPO between $32 and $34 per share.  The New York-based startup plans to trade on the New York Stock Exchange under the ticker “OSCR.”

  • New Single-Payer Bill Intensifies Newsom’s Political Peril

    Use Our Content It can be republished for free. SACRAMENTO — A group of Democratic state lawmakers introduced legislation Friday to create a single-payer health care system to cover all Californians, immediately defining the biggest health policy debate of the year and putting enormous political pressure on Gov. Gavin Newsom. The Democratic governor faces the […]

  • Why Biden Has a Chance to Cut Deals With Red State Holdouts on Medicaid

    President Joe Biden has an unexpected opening to cut deals with red states to expand Medicaid, raising the prospect that the new administration could extend health protections to millions of uninsured Americans and reach a goal that has eluded Democrats for a decade. The opportunity emerges as the covid-19 pandemic saps state budgets and strains […]

  • Los mercados de seguros de salud reabrieron. Esto es lo que necesitas saber

    Para quienes han estado sin seguro médico durante la pandemia, el alivio ya está a la vista. En enero, el presidente Joe Biden firmó una orden ejecutiva para abrir el mercado federal de seguros de salud durante tres meses, desde el lunes 15, para que las personas sin seguro puedan comprar un plan y o […]