Insurance startup Bind Benefits just raised $105 million in a Series B funding round to further expand into the fully insured market. CEO Tony Miller sees the company’s health plan product as a way for employers to stay agile while offering insurance in a rapidly… Read More »How Bind Benefits’ CEO will use $105M to upend the health insurance market
During the final presidential debate, President Donald Trump claimed that 180 million people would lose their private health insurance to socialized medicine if the Democratic presidential nominee, former Vice President Joe Biden, is elected president. “They have 180 million people, families under what he wants… Read More »Did Trump Confuse the Public Option With ‘Medicare for All’?
In the second and final debate of the 2020 presidential race, President Donald Trump and former Vice President Joe Biden sparred over Trump’s handling of the pandemic and Biden’s plan to reform health care. In stark contrast to the first debate, there was more policy… Read More »In Tamer Debate, Trump and Biden Clash (Again) on President’s Pandemic Response
Facing a pandemic, record unemployment and unknown future costs for COVID-19 treatments, health insurers selling Affordable Care Act plans to individuals reacted by lowering rates in some areas and, overall, issuing only modest premium increases for 2021. “What’s been fascinating is that carriers in general… Read More »Even With ACA’s Fate in Flux, Open Enrollment Starts Soon. Here’s What’s New.
After Nebraskans cast their vote for Medicaid expansion in 2018, the state is finally expanding coverage to more residents. As part of the state’s rollout, it split its expanded Medicaid plans into two tiers, with work and other requirements to access dental and vision coverage.
When it announced plans to go public through a blank-check company, Clover Health shared ambitious projections for its future membership. Much of that growth is pinned on plans to launch a direct contracting business.
Health insurance costs for Americans who get their coverage through work continued a relentless march upward with average family premiums rising 4% to $21,342 this year, according to a study published Thursday. The annual survey by KFF found workers on average are paying nearly $5,600… Read More »Job-Based Health Insurance Costs Are Up 4% This Year, 55% in Past Decade
Within one day, President Donald Trump announced his COVID diagnosis and was admitted to Walter Reed National Military Medical Center for treatment. The flurry of events was stunning, confusing and triggered many questions. What was his prognosis? When was he last tested for COVID-19? What… Read More »Does the Federal Health Information Privacy Law Protect President Trump?
The Affordable Care Act, facing its first test during a deep recession, is providing a refuge for some — but by no means all — people who have lost health coverage as the economy has been battered by the coronavirus pandemic. New studies, from both… Read More »Refuge in the Storm? ACA’s Role as Safety Net Is Tested by COVID Recession
Throughout the 2020 election cycle, candidates’ positions on health care have been particularly important for voters with underlying and often expensive medical needs — in short, those with preexisting conditions. It’s no surprise, then, that protections for people who have chronic health problems like diabetes… Read More »Fighting for Patient Protections While Attacking ACA — Hard to Have It Both Ways
Medicare Advantage startup Clover Health will go public in a blank-check acquisition led by billionaire Chamath Palihapitiya. The deal will value Clover at $3.7 billion.
The insurer plans to increase the footprint for its Medicare Advantage plans by 50%, adding plans in 300 additional counties.
KHN senior correspondent Sarah Jane Tribble appeared on Newsy’s “Morning Rush” on Thursday to discuss rural hospital closures and KHN’s brand-new “Where It Hurts” podcast. Click here to watch Tribble on Newsy Tribble hosts “No Mercy,” the first season of “Where It Hurts.” Click here… Read More »KHN on the Air This Week
The first minutes of Tuesday’s presidential debate immediately turned to how President Donald Trump’s Supreme Court nominee to replace Justice Ruth Bader Ginsburg could undo the Affordable Care Act and its protections for people with preexisting conditions. “There’s 100 million people that have preexisting conditions,”… Read More »Biden’s in the Ballpark on How Many People Have Preexisting Conditions
The two companies had been negotiating a six-year value-based contract prior to the start of the pandemic. Allina and BCBS of Minnesota expect the agreement will affect roughly 130,000 patients.
La temporada de influenza se verá diferente este año, ya que los Estados Unidos se enfrentan a una pandemia de coronavirus que ya ha matado a más de 176.000 personas. Muchos estadounidenses son reacios a ir al médico y los funcionarios de salud pública temen… Read More »COVID + Influenza: éste es un buen año para vacunarse, aconsejan expertos
Flu season will look different this year, as the country grapples with a coronavirus pandemic that has killed more than 172,000 people. Many Americans are reluctant to visit a doctor’s office and public health officials worry people will shy away from being immunized. Although sometimes… Read More »COVID + Influenza: This Is a Good Year to Get a Flu Shot, Experts Advise
In the 2014 elections, Republicans rode a wave of anti-Affordable Care Act sentiment to pick up nine Senate seats, the largest gain for either party since 1980. Newly elected Republicans such as Cory Gardner in Colorado and Steve Daines in Montana had hammered their Democratic… Read More »Opposition to Obamacare Becomes Political Liability for GOP Incumbents
Can’t see the audio player? Click here to listen on SoundCloud. The “What the Health?” panelists are taking a break for two weeks. But since the Supreme Court recently scheduled arguments in the case challenging the constitutionality of the Affordable Care Act, it seemed like a… Read More »KHN’s ‘What the Health?’ Replay: What’s at Stake When High Court Hears ACA Case
Before the prime-time GOP showcase began, President Donald Trump took to the podium Monday afternoon and delivered an approximately one-hour campaign-style speech to delegates after he was officially renominated by the Republican Party as its candidate for president. His comments were wide-ranging, and our partners… Read More »Republican Convention, Day 1: A Campaign-Style Trump Speech and More
In late August 2019, Shannon Harness awoke to serious pain in the lower right side of his abdomen — a telltale sign of appendicitis. He booked it to the emergency room of the only hospital in the county: Heart of the Rockies Regional Medical Center… Read More »Veteran’s Appendectomy Launches Excruciating Months-Long Battle Over Bill
In a near-empty arena on the river in his hometown of Wilmington, Delaware, former Vice President Joe Biden accepted the Democratic nomination for president, promising hope over fear, fairness over privilege, love over hate. And, he said, “Facts over fiction.” Let’s see about that. Our… Read More »Democratic Convention, Night 4: ‘Facts Over Fiction’ in Biden’s Speech
Can’t see the audio player? Click here to listen on SoundCloud. Democrats have shown a remarkably united front, including on health care, in their socially distant, made-for-TV convention this week. That’s likely due, at least in part, to the physical separation of party members who disagree… Read More »KHN’s ‘What The Health?’: Democrats in Array (For Now)
The Cleveland Clinic struck a partnership with CVS Health subsidiary Aetna to form a new accountable care organization (ACO). The two companies plan to launch a co-branded insurance plan this fall.
An attack ad, which was released in mid-July, states that Montana Gov. Steve Bullock, a Democratic candidate for the Senate, supports a government-run health care program that would wreak havoc on the state’s health care infrastructure. “Bullock’s health care plan will force rural hospitals to… Read More »GOP Senate Ad Misrepresents Mont. Governor’s Stance on Rural Hospitals, Public Option
Pennsylvania is rolling out its new “Pennie” this fall: a state-run insurance exchange that officials say will save residents collectively millions of dollars on next year’s health plan premiums. Since the Affordable Care Act’s marketplaces opened for enrollment in fall 2013, Pennsylvania, like most states,… Read More »‘Pennie’-Pinching States Take Over Obamacare Exchanges From Feds
During the height of the Covid-19 pandemic, all of the seven largest commercial insurers saw their profits rise, with some seeing their profits double. Will they have to pay some of it back?
For Dr. Gabe Charbonneau, a primary care doctor in Stevensville, Montana, the coronavirus pandemic is an existential threat. Charbonneau, 43, his two partners and 10 staff members are struggling to keep their rural practice alive. Patient volume is slowly returning to pre-COVID levels. But the… Read More »Primary Care Doctors Look at Payment Overhaul After Pandemic Disruption
For the quarter ending on June 30, when many health systems face a rising number of Covid-19 cases, the Kaiser Foundation Health Plan more than doubled its net income to $4.5 billion. The nonprofit managed care plans attributed the increase to reduced operating expenses and… Read More »Kaiser sees Q2 net income more than double to $4.5B
Can’t see the audio player? Click here to listen. When you need medical care, it can be a lot like entering a casino — playing for your financial life with the deck stacked against you. But in this episode, reporter Celia Llopis-Jepsen offers insight and tips… Read More »‘An Arm and a Leg’: Financial Self-Defense School Is Now in Session
A recently unsealed whistleblower case filed by the Department of Justice accuses Cigna of fraudulently overbilling for its Medicare Advantage plans. Allegations claim the company submitted unsupported diagnoses that resulted in “billions” in overpayments.
Can’t see the audio player? Click here to listen on SoundCloud. President Donald Trump keeps promising to unveil a comprehensive plan to replace the Affordable Care Act, but it keeps not appearing. However, this week he did order an expansion of telehealth for Medicare beneficiaries and… Read More »KHN’s ‘What the Health?’: Still Waiting for That Trump Health Plan
Despite strong opposition from Republicans and rural voters, Missouri on Tuesday joined 37 states and the District of Columbia in expanding its Medicaid program. Voters in Missouri approved creating a state constitutional amendment that will open Medicaid eligibility to include healthy adults starting July 1,… Read More »Missouri Voters Approve Medicaid Expansion Despite GOP Resistance
Premiums for health plans sold through Covered California, the state’s Affordable Care Act insurance exchange, will rise an average of 0.6% next year — the smallest hike since the exchange started providing coverage in 2014, the agency announced Tuesday. The modest increase follows an average… Read More »Covered California Announces Record-Low Rate Hike for 2021
Insurance startup Oscar Health plans to expand to 19 new markets next year, pending regulatory approval. The company will offer individual and family health plans in four new states, and will expand its presence in existing states.
When COVID-19 smacked the United States in March and April, health plans feared medical costs could skyrocket, jacking up premiums drastically in 2021, when millions of the newly unemployed might still be out of work. But something else happened: Non-COVID care collapsed as hospitals emptied… Read More »Don’t Count on Lower Premiums Despite Pandemic-Driven Boon for Insurers
ST. LOUIS — Haley Organ thought she had everything figured out. After graduating from a small private college just outside Boston, she earned her master’s degree, entered the workforce and eventually landed a corporate job here as a data analyst. Life seemed to be going… Read More »Missourians to Vote on Medicaid Expansion as Crisis Leaves Millions Without Insurance
When Will Lightbourne looked at the statistics behind California’s coronavirus cases, the disparities were “blindingly clear”: Blacks and Latinos are dying at higher rates than most other Californians. As of Monday, Latinos account for 45.6% of coronavirus deaths in a state where they make up… Read More »Medi-Cal Agency’s New Head Wants to Tackle Disparities and Racism
Reversing a three-year decline, the number of people covered by Medicaid nationwide rose markedly this spring as the impact of the recession caused by the outbreak of COVID-19 began to take hold. Yet, the growth in participation in the state-federal health insurance program for low-income… Read More »The COVID-19 Downturn Triggers Jump in Medicaid Enrollment
NEW YORK — As the coronavirus spread silently through New York City early this year, Deborah Koeppel had an appointment with her cardiologist and two visits with her primary care doctor. Both physicians are members of Concorde Medical Group, a practice in Manhattan with an… Read More »Last Thing Patients Need During Pandemic: Being Last to Know a Doctor Left Network
President Donald Trump came into office vowing to repeal and replace Obamacare. While he successfully neutralized the health care law’s requirement that everyone carry insurance, the law remains in effect. When Fox News host Chris Wallace noted that Trump has yet to put forward a replacement… Read More »With DACA Ruling, Did Supreme Court Grant Trump New Powers To Reshape Health Care?
Humana will send 1 million screening kits to its members for managing diabetes and screening for colorectal cancer. The at-home tests are intended to offset screenings and other preventive care being pushed back due to Covid-19.
The predictions were dire: Coronavirus lockdowns would put millions of Americans out of work, stripping them of their health insurance and pushing them into Medicaid, the health insurance program for low-income people. In California, Gov. Gavin Newsom’s administration projected that the pandemic would force about… Read More »Medicaid Mystery: Millions of Enrollees Haven’t Materialized in California
Everyone involved even tangentially in health care today is completely consumed by the coronavirus pandemic, as they should be. But the pandemic is accelerating a problem that used to be front and center in health circles: the impending insolvency of Medicare. With record numbers of… Read More »Another Problem on the Health Horizon: Medicare Is Running Out of Money
Clover Health said it plans to triple its footprint in the next year, pending CMS approval. But the insurer has also posted a net loss in recent years.
Kaia Health, a startup making an app to help users manage back pain, touted the results of a large, randomized controlled trial using its app. The company currently markets its system to employers, but hopes to make it available as a covered benefit in the… Read More »Digital health startup Kaia hopes to win over insurers with results of back pain study
Molina will acquire Passport Health Plan’s Medicaid and dual-eligible business for $20 million. The Kentucky-based company is a long-standing provider of Medicaid managed care plans, but lost a bid with the state earlier this year.
People who’ve been laid off or furloughed from their jobs now have significantly more time to decide whether to hang on to their employer-sponsored health insurance, according to a recent federal rule. Under the federal law known as COBRA, people who lose their job-based coverage… Read More »Administration Eases Rules to Give Laid-Off Workers More Time to Sign Up for COBRA
In advance of an upcoming road trip with her elderly parents, Wendy Epstein’s physician agreed it would be “prudent” for her and her kids to get tested for COVID-19. Seeing the tests as a “medical need,” the doctor said insurance would likely pay for them,… Read More »For COVID Tests, the Question of Who Pays Comes Down to Interpretation
The Friday Breeze Want to read the best and most provocative stories from the week? Welcome to the Friday Breeze, where we compile them all — so you’re set with your weekend reading. While you, loyal reader, wait for a wonderful new permanent Friday Breeze… Read More »Must-Reads of the Week
GoHealth, an online insurance broker focusing on Medicare Advantage plans, went public on Wednesday for $914 million. The company will trade on Nasdaq under the ticker “GOCO.”
Researchers at the Urban Institute found that up to 10 million people could lose their job-based insurance due to Covid-19 by the end of the year.
“First off, it’s in statute already in HIPAA that preexisting conditions are covered.” Health and Human Services Secretary Alex Azar, on July 9, speaking at a virtual summit sponsored by The Hill newspaper One of the most popular features of the Affordable Care Act is… Read More »Azar Says Federal Law Had Preexisting Conditions Covered Before ACA. Not So Much.