Insurance

‘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, …

‘An Arm and a Leg’: They Turned Grief Into Action Read More »

The Solution to Au Pairs’ Health Coverage Gaps May Be Simple: ACA Plans

In 2016, Isis Mabel, of Mexico, wanted to improve her English. On advice from an aunt, she enrolled with an au pair agency to come to the United States to live with a family and care for the children. The job typically pays about $200 a week on top of lodging and meals. She said …

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Dentistas eliminan los problemas de las personas sin seguro ofreciéndoles ellos mismos planes

David White, dentista de Nevada, ha visto dientes enfermos y podridos en la boca de pacientes que habitualmente posponen sus chequeos y evitan procedimientos menores como empastes. Si bien la fobia dental es un factor, White dijo que la razón principal por la que las personas no se tratan es el costo. Para ayudar a …

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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 …

Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans Read More »

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 …

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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 …

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Census: Insured Population Holds Steady, With a Slight Shift From Private to Public Coverage

Despite a pandemic-fueled recession, the number of uninsured Americans has increased only slightly since 2018, according to Census Bureau health insurance data released Tuesday. Twenty-eight million people, or 8.6% of Americans, were uninsured for all of 2020. In 2019, 8% of people were uninsured during the full year; in 2018, it was 8.5%. During a …

Census: Insured Population Holds Steady, With a Slight Shift From Private to Public Coverage Read More »

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 …

Health Care Unions Defending Newsom From Recall Will Want Single-Payer Payback Read More »

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 …

Georgia Eyes New Medicaid Contract. But How Is the State Managing Managed Care? Read More »

California Set to Spend Billions on Curing Homelessness and Caring for ‘Whole Body’ Politic

OAKLAND, Calif. — Living unmedicated with schizophrenia and bipolar disorder, Eugenia Hunter has a hard time recalling how long she’s been staying in the tent she calls home at the bustling intersection of San Pablo Avenue and Martin Luther King Jr. Way in Oakland’s hip Uptown neighborhood. Craft coffee shops and weed dispensaries are plentiful …

California Set to Spend Billions on Curing Homelessness and Caring for ‘Whole Body’ Politic Read More »

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 …

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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 …

Beneficiarios de Medicaid se vacunan mucho menos contra covid Read More »

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. …

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

Medicaid Vaccination Rates Founder as States Struggle to Immunize Their Poorest Residents

Medicaid enrollees are getting vaccinated against covid-19 at far lower rates than the general population as states search for the best strategies to improve access to the shots and persuade those who remain hesitant. Efforts by state Medicaid agencies and the private health plans that most states pay to cover their low-income residents has been …

Medicaid Vaccination Rates Founder as States Struggle to Immunize Their Poorest Residents Read More »

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 …

Headed Away to School? Here’s What Students With Health Issues Need to Know Read More »

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 …

Readers and Tweeters Ponder Vaccines and Points of Fairness Read More »

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 …

Why Doesn’t Medicare Cover Services So Many Seniors Need? Read More »

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 …

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

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 …

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

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 …

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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 …

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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 …

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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 …

Sign-Up Window for Free COBRA Coverage for Many Laid-Off Workers Closes This Week Read More »

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 …

Bye-Bye to Health Insurance ‘Birthday Rule’? Kansas Lawmaker Floats Fix Read More »

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 …

Contraception Is Free to Women, Except When It’s Not Read More »

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 …

Readers and Tweeters Connect the Dots on Topics From Vaccine Development to Long Covid Read More »

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,” …

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

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 — …

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Hospital Prices Must Now Be Transparent. For Many Consumers, They’re Still Anyone’s Guess.

A colonoscopy might cost you or your insurer a few hundred dollars — or several thousand, depending on which hospital or insurer you use. Long hidden, such price variations are supposed to be available in stark black and white under a Trump administration price transparency rule that took effect at the start of this year. …

Hospital Prices Must Now Be Transparent. For Many Consumers, They’re Still Anyone’s Guess. Read More »

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 …

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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 …

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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 …

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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 …

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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 …

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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 …

Pandemic Swells Medicaid Enrollment to Record 80 Million People Read More »

‘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, …

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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 …

Colorado Bill Aims to Give Farmworkers Easier Access to Medical Care Read More »

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 …

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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. …

Can a Subscription Model Fix Primary Care in the US? Read More »

Study: Poor care access, higher costs more likely with private than public insurance

People with private insurance report poorer access to care, higher costs and lower satisfaction as compared to those with public insurance plans, a new study shows. As the debate over health insurance reform continues, policymakers should consider efforts that expand Medicare and increase protections for those with private insurance.

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 …

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Many New Moms Get Kicked Off Medicaid 2 Months After Giving Birth. Illinois Will Change That.

The U.S. is the only industrialized nation in which the maternal death rate has been rising. Each year, about 700 deaths are due to pregnancy, childbirth or subsequent complications, according to the Centers for Disease Control and Prevention. This story also ran on NPR. It can be republished for free. When someone dies while pregnant or within a …

Many New Moms Get Kicked Off Medicaid 2 Months After Giving Birth. Illinois Will Change That. Read More »

Coverage parity for mental health, substance abuse, a key focus for insurance regulators

Health insurers are prohibited from placing unfavorable limits on mental health and substance abuse benefits, and yet, many do. Federal and state regulators are taking aim at these practices and making the enforcement of the Mental Health Parity and Addiction Equity Act of 2008 a key focus.

From Racial Justice to Dirty Air, California’s New AG Plots a Progressive Health Care Agenda

California Attorney General Rob Bonta, a longtime Democratic state lawmaker, comes to his new role well known for pursuing an unabashedly progressive agenda on criminal justice issues. He has pushed for legislation to eliminate cash bail and to ban for-profit prisons and detention centers. But Bonta also has a distinctive record on health care, successfully …

From Racial Justice to Dirty Air, California’s New AG Plots a Progressive Health Care Agenda Read More »

Caring for an Aging Nation

USE OUR CONTENT This story can republished for free. Please contact KHNweb@kff.org 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 …

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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 …

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

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 …

Enough to Wreck Their Rest: $10,322 for a Sleep Study Read More »

Confronting Our ‘Frailties’: California’s Assembly Leader Reflects on a Year of Covid

SACRAMENTO, Calif. — When his 20-month-old daughter developed a rash earlier this month, Anthony Rendon did what many other parents do when their child is sick: The speaker of the California Assembly took Vienna to her pediatrician — but he did so via video from the comfort and safety of his home. This story also …

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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 …

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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 …

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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 …

You’ve Added Your Kids to Your Health Plan. What About Mom? Read More »

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 …

From Covid Coverage to ‘Public Option’ Plans, Journalists Delve Into Details Read More »

Covid Testing Has Turned Into a Financial Windfall for Hospitals and Other Providers

Pamela Valfer needed multiple covid tests after repeatedly visiting the hospital last fall to see her mother, who was being treated for cancer. Beds there were filling with covid patients. Valfer heard the tests would be free. This story also ran on Fortune. It can be republished for free. So, she was surprised when the …

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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 …

Hit by Higher Prices for Gear, Doctors and Dentists Want Insurers to Pay Read More »

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 …

Covered California Says Health Insurance Just Got Too Cheap to Ignore Read More »

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 …

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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 …

Watch: What Happens When Car and Health Insurance Collide Read More »

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. …

Time to Say Goodbye to Some Insurers’ Waivers for Covid Treatment Fees Read More »

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 …

After Accident, Patient Crashes Into $700,000 Bill for Spine Surgery Read More »

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 …

Strides Against HIV/AIDS Falter, Especially in the South, as Nation Battles Covid Read More »

Humana Health Plan Overcharged Medicare by Nearly $200 Million, Federal Audit Finds

A Humana Inc. health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were, according to a new federal audit, which seeks to claw back the money. This story also ran on NPR. It can be republished for free. The Health and Human Services Office of …

Humana Health Plan Overcharged Medicare by Nearly $200 Million, Federal Audit Finds Read More »

‘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 …

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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 …

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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 …

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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 …

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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 …

Journalists Dish on Vaccination Loopholes and Alliances Read More »

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 …

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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 …

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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 …

Lots of Health Insurance Help in Covid Relief Law — But Do Your Homework First Read More »

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 …

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

Under New Cost-Cutting Medicare Rule, Same Surgery, Same Place, Different Bill Read More »

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 …

Journalists Analyze the Covid Relief Bill Read More »

Blue Shield Spent Years Cultivating a Relationship with Newsom. It Got the State Vaccine Contract.

SACRAMENTO — Gavin Newsom was just making a name for himself as mayor of San Francisco in 2005 when Blue Shield of California wrote him its first major check. USE OUR CONTENT It can be republished for free. The young, business-friendly Democrat had exploded onto the national scene the year before by issuing same-sex marriage …

Blue Shield Spent Years Cultivating a Relationship with Newsom. It Got the State Vaccine Contract. Read More »

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 …

Covid-Inspired Montana Health Insurance Proposal Wouldn’t Kick In for 2 Years Read More »

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 …

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

‘Painless’ Glucose Monitors Pushed Despite Little Evidence They Help Most Diabetes Patients

In the nation’s battle against the diabetes epidemic, the go-to weapon being aggressively promoted to patients is as small as a quarter and worn on the belly or arm. This story also ran on NBC News. It can be republished for free. A continuous glucose monitor holds a tiny sensor that’s inserted just under the …

‘Painless’ Glucose Monitors Pushed Despite Little Evidence They Help Most Diabetes Patients Read More »

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 …

Analysis: The Trump Health Care Policies That Deserve to Stick Around Read More »

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 …

The Boom in Out-of-State Telehealth Threatens In-State Providers Read More »

For Covid ‘Long Haulers,’ Battling for Disability Benefits Adds Aggravation to Exhaustion

Use Our Content It can be republished for free. Rickie Andersen took a brief break from work in March after she fell ill. Her cough, fever and chills were typical covid-19 symptoms, but coronavirus tests were so scarce she could not obtain one to confirm the diagnosis. After Andersen returned to her job as an …

For Covid ‘Long Haulers,’ Battling for Disability Benefits Adds Aggravation to Exhaustion Read More »

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 …

Pandemic Aid Package Includes Relief From High Premiums Read More »

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 …

Readers and Tweeters Dispense Timely Advice for Difficult Times Read More »

Becerra Has Long Backed Single-Payer. That Doesn’t Mean It Will Happen if He’s HHS Secretary.

“Becerra supports Bernie’s government takeover of your health care, eliminating your employer-provided coverage.” — TV ad funded by Cotton for Senate, Feb. 22 This story was produced in partnership with PolitiFact. It can be republished for free. A digital ad running in Georgia and New Hampshire says Xavier Becerra, President Joe Biden’s nominee for Health and …

Becerra Has Long Backed Single-Payer. That Doesn’t Mean It Will Happen if He’s HHS Secretary. Read More »

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 …

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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: …

New California Law Makes It Easier to Get Care for Mental Health and Substance Abuse Read More »

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 …

New Single-Payer Bill Intensifies Newsom’s Political Peril Read More »

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 …

Why Biden Has a Chance to Cut Deals With Red State Holdouts on Medicaid Read More »

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 …

Los mercados de seguros de salud reabrieron. Esto es lo que necesitas saber Read More »

The ACA Marketplace Is Open Again for Insurance Sign-Ups. Here’s What You Need to Know.

This story also ran on NPR. It can be republished for free. For people who’ve been without health insurance during the pandemic, relief is in sight. In January, President Joe Biden signed an executive order to open up the federal health insurance marketplace for three months as of Monday so uninsured people can buy a …

The ACA Marketplace Is Open Again for Insurance Sign-Ups. Here’s What You Need to Know. Read More »

Tech Companies Mobilize to Schedule Vaccine Appointments, But Often Fall Short

This story also ran on Fortune. It can be republished for free. On Jan. 14 at 8:43 p.m., Patrick McKenzie tweeted a plea for tech engineers to help him set up a website to track covid-19 vaccine availability in California. McKenzie, who heads a Bay Area financial services tech company, issued the call to “anyone …

Tech Companies Mobilize to Schedule Vaccine Appointments, But Often Fall Short Read More »

KHN’s ‘What the Health?’: The Long Road to Unwinding Trump Health Policies

Can’t see the audio player? Click here to listen on SoundCloud. Thursday was “health day” in President Joe Biden’s sprint to launch his presidency, and he signed two executive orders addressing health coverage and women’s reproductive rights. The orders will reopen enrollment under the Affordable Care Act from February to May and reverse the so-called Mexico …

KHN’s ‘What the Health?’: The Long Road to Unwinding Trump Health Policies Read More »

Baby Blues: First-Time Parents Blindsided by ‘the Birthday Rule’ and a $207,455 NICU Bill

In the nine months leading up to her due date, Kayla Kjelshus and her husband, Mikkel, meticulously planned for their daughter’s arrival. This story also ran on NPR. It can be republished for free. Their long to-do list included mapping out their family’s health insurance plan and registering for baby gear and supplies. They even …

Baby Blues: First-Time Parents Blindsided by ‘the Birthday Rule’ and a $207,455 NICU Bill Read More »

Insurtech startup Sidecar Health’s valuation hits $1B  

The new startup unicorn’s insurance product enables members to shop for medical services and pay directly for care. The company raised $125 million in a recent funding round, boosting its valuation, which it will use to increase its footprint and launch new products.

Health Issues Carried Weight on the Campaign Trail. What Could Biden Do in His First 100 Days?

Joe Biden ran on an expansive health care platform during his 2020 presidential campaign, with a broad array of promises such as adding a government-sponsored health plan to the Affordable Care Act and lowering prescription drug prices. Perhaps most significantly, he pledged to get control of the covid pandemic that claimed more than 400,000 American lives …

Health Issues Carried Weight on the Campaign Trail. What Could Biden Do in His First 100 Days? Read More »

After a Decade of Lobbying, ALS Patients Gain Faster Access to Disability Payments

Anita Baron first noticed something was wrong in August 2018, when she began to drool. Her dentist chalked it up to a problem with her jaw. Then her speech became slurred. She managed to keep her company, which offers financing to small businesses, going, but work became increasingly difficult as her speech worsened. Finally, nine …

After a Decade of Lobbying, ALS Patients Gain Faster Access to Disability Payments Read More »

‘An Arm and a Leg’: Host Dan Weissmann Talks Price Transparency on ‘Axios Today’

Can’t see the audio player? Click here to listen. As we settle into the new year, we have two small doses of good news. First, a new federal rule could help cut through one health care issue. Host Dan Weissmann talked about the rule — which requires hospitals to make public the prices they negotiate with …

‘An Arm and a Leg’: Host Dan Weissmann Talks Price Transparency on ‘Axios Today’ Read More »

Aunque controlen el Senado, demócratas necesitarán apoyo republicano en temas clave de salud

Ante la pandemia, los demócratas han abogado por ayudas más generosas, más presión sobre las farmacéuticas para que bajen los precios y más atención al racismo sistémico en la atención de salud. El 20 de enero, con el control del Senado y la Cámara de Representantes, tendrán el poder de elegir qué propuestas de salud …

Aunque controlen el Senado, demócratas necesitarán apoyo republicano en temas clave de salud Read More »

Even With Senate Control, Democrats Will Need Buy-In From GOP on Key Health Priorities

Use Our Content It can be republished for free. Democrats have argued for more generous pandemic relief, more pressure on drugmakers to lower prices and more attention to systemic racism in health care. On Jan. 20, with control of the Senate and the House of Representatives, they’ll have the power to choose which health care …

Even With Senate Control, Democrats Will Need Buy-In From GOP on Key Health Priorities Read More »

Trump Administration Approves First Medicaid Block Grant, in Tennessee

Use Our Content It can be republished for free. With just a dozen days left in power, the Trump administration on Friday approved a radically different Medicaid financing system in Tennessee that for the first time would give the state broad authority in running the health insurance program for the poor in exchange for capping …

Trump Administration Approves First Medicaid Block Grant, in Tennessee Read More »

Biden’s First Order of Business May Be to Undo Trump’s Policies, but It Won’t Be Easy

The party split in Congress is so slim that, even with Democrats technically in the majority, passing major health care legislation will be extremely difficult. So speculation about President-elect Joe Biden’s health agenda has focused on the things he can accomplish using executive authority. Although there is a long list of things he could do, …

Biden’s First Order of Business May Be to Undo Trump’s Policies, but It Won’t Be Easy Read More »

KHN’s ‘What the Health?’: Georgia Turns the Senate Blue

Can’t see the audio player? Click here to listen on SoundCloud. Surprise Democratic victories in Georgia’s two runoff elections this week will give Democrats control of the Senate, which means they will be in charge of both houses of Congress and the White House for the first time since 2010. Although the narrow majorities in the …

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Illinois, primer estado en ofrecer cobertura médica a adultos mayores indocumentados

Como jefa de enfermería en uno de los hospitales más concurridos de la red de seguridad de atención médica de Chicago, Raquel Prendkowski ha sido testigo del devastador número de víctimas que COVID-19 ha causado entre los residentes más vulnerables de la ciudad, incluyendo a personas que no tienen seguro médico por su estatus migratorio. …

Illinois, primer estado en ofrecer cobertura médica a adultos mayores indocumentados Read More »

Illinois Is First in the Nation to Extend Health Coverage to Undocumented Seniors

As a nurse manager for one of Chicago’s busiest safety-net hospitals, Raquel Prendkowski has witnessed covid-19’s devastating toll on many of the city’s most vulnerable residents — including people who lack health insurance because of their immigration status. Some come in so sick they go right to intensive care. Some don’t survive. “We’re in a …

Illinois Is First in the Nation to Extend Health Coverage to Undocumented Seniors Read More »

‘An Arm and a Leg’: A Look Back at 2020 — What We Learned and Where We’re Headed

Can’t see the audio player? Click here to listen. This episode turns the tables: Host Dan Weissmann gets interviewed about what he learned in 2020 and what’s ahead for the show — with T.K. Dutes, a radio host and podcast-maker who is also a former nurse, so she knows a thing or two about the health …

‘An Arm and a Leg’: A Look Back at 2020 — What We Learned and Where We’re Headed Read More »

Many Health Plans Now Must Cover Full Cost of Expensive HIV Prevention Drugs

Ted Howard started taking Truvada a few years ago because he wanted to protect himself against HIV, the virus that causes AIDS. But the daily pill was so pricey he was seriously thinking about giving it up. Under his insurance plan, the former flight attendant and customer service instructor owed $500 in copayments every month …

Many Health Plans Now Must Cover Full Cost of Expensive HIV Prevention Drugs Read More »

Hospital Prices Just Got a Lot More Transparent. What Does This Mean for You?

Hospitals face the new year with new requirements to post price information they have long sought to obscure: the actual prices negotiated with insurers and the discounts they offer their cash-paying customers. The move is part of a larger push by the Trump administration to use price transparency to curtail prices and create better-informed consumers. …

Hospital Prices Just Got a Lot More Transparent. What Does This Mean for You? Read More »

Democrats Are Running Hard on Health Care in Georgia’s Senate Runoffs. Republicans? Not So Much.

This story is from a reporting partnership that includes WABE, NPR and KHN. It can be republished for free. Vice President Mike Pence was the clear celebrity draw at a Nov. 20 campaign event for Georgia’s two incumbent U.S. senators, Kelly Loeffler and David Perdue. Both Republicans are fighting to keep their seats against two …

Democrats Are Running Hard on Health Care in Georgia’s Senate Runoffs. Republicans? Not So Much. Read More »

KHN’s ‘What the Health?’: All I Want for Christmas Is a COVID Relief Bill

Can’t see the audio player? Click here to listen on SoundCloud. Congress appears to be inching ever closer to agreement on a long-delayed COVID-19 relief bill, which would extend unemployment insurance and other emergency programs set to expire in the next several days. That bill, however, apparently will not include the top-priority items for both political …

KHN’s ‘What the Health?’: All I Want for Christmas Is a COVID Relief Bill Read More »

Readers and Tweeters Defend Front-Line Nurses and Blind Us With Science

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. The demand for skilled nurses during the pandemic is through the roof! Travel nurses command a hefty salary and they are worth every penny… #COVID19 #pandemic #RN https://t.co/gYQpkHqaoX — Talmage …

Readers and Tweeters Defend Front-Line Nurses and Blind Us With Science Read More »

‘An Arm and a Leg’: Shopping for Health Insurance? Here’s How One Family Tried to Pick a Plan

Can’t see the audio player? Click here to listen. When host Dan Weissmann and his wife set out to pick a health insurance plan for next year, they realized that keeping the plan they have means paying $200 a month more. But would a “cheaper” plan cost them more in the long run?  It depends. And …

‘An Arm and a Leg’: Shopping for Health Insurance? Here’s How One Family Tried to Pick a Plan Read More »

With Becerra as HHS Pick, California Plots More Progressive Health Care Agenda

SACRAMENTO — President-elect Joe Biden didn’t back “Medicare for All” during his campaign. Yet his choice of California Attorney General Xavier Becerra to serve in the nation’s top health care post is fueling California lawmakers’ most progressive health care dreams, including pursuing a government-run single-payer system at the state level. “Now it’s much more real, …

With Becerra as HHS Pick, California Plots More Progressive Health Care Agenda Read More »

Xavier Becerra en sus propias palabras: “La atención de salud es un derecho”

El presidente electo Joe Biden nombró al fiscal general de California, Xavier Becerra, para dirigir el Departamento de Salud y Servicios Humanos (HHS) de los Estados Unidos. Becerra, quien sería el primer secretario latino del HHS, ha tomado algunas posiciones innovadoras en atención de salud, especialmente desde que se convirtió en fiscal general, en 2017. …

Xavier Becerra en sus propias palabras: “La atención de salud es un derecho” Read More »

Xavier Becerra in His Own Words: ‘Health Care Is a Right’

President-elect Joe Biden has tapped California Attorney General Xavier Becerra to lead the U.S. Department of Health and Human Services. Becerra, who would be the nation’s first Latino HHS secretary, has taken some ground-breaking positions on health care, especially since he became attorney general in 2017. He has sued the Trump administration dozens of times …

Xavier Becerra in His Own Words: ‘Health Care Is a Right’ Read More »

California Lawmakers to Newsom: Give All Immigrants Health Coverage

Use Our Content It can be republished for free. SACRAMENTO — California Democratic lawmakers so far have failed to convince Gov. Gavin Newsom that the state can afford to spend an estimated $2.6 billion a year to expand its Medicaid program to all unauthorized immigrants. Now, they’re trying a new strategy. Rather than working independently, …

California Lawmakers to Newsom: Give All Immigrants Health Coverage Read More »

Trump Rule Gives Small Companies a New Tool to Help Workers Buy Health Coverage

Until October, Andrea LaRew was paying $950 a month for health insurance through her job at the Northwest Douglas County Chamber & Economic Development Corp. in the metro Denver area. Her company didn’t contribute anything toward the premium. Plus, LaRew and her husband had a steep $13,000 deductible for the plan. But the coverage and …

Trump Rule Gives Small Companies a New Tool to Help Workers Buy Health Coverage Read More »

During ACA Open Enrollment, Picking a Plan Invites New COVID Complications

People buying their own health insurance have even more to think about this year, particularly those post-COVID-19 patients with lingering health concerns, the “long haulers,” who join the club of Americans with preexisting conditions. What type of plan is best for someone with an unpredictable, ongoing medical concern? That question is popping up on online …

During ACA Open Enrollment, Picking a Plan Invites New COVID Complications Read More »

After Kid’s Minor Bike Accident, Major Bill Sets Legal Wheels in Motion

Adam Woodrum was out for a bike ride with his wife and kids on July 19 when his then 9-year-old son, Robert, crashed. “He cut himself pretty bad, and I could tell right away he needed stitches,” said Woodrum. This story also ran on NPR. It can be republished for free. Because they were on …

After Kid’s Minor Bike Accident, Major Bill Sets Legal Wheels in Motion Read More »

Were You Notified About Missing Tax Forms for Your ACA Subsidy? Blame COVID.

The notice from the federal health insurance marketplace grabbed Andrew Schenker’s attention: ACT NOW: YOU’RE AT RISK OF LOSING FINANCIAL ASSISTANCE STARTING JANUARY 1, 2021. As he read the notice, though, the Blacksburg, Virginia, resident became exasperated. Schenker, his wife and their teenage son have a bronze-level marketplace plan. Based on their income of about …

Were You Notified About Missing Tax Forms for Your ACA Subsidy? Blame COVID. Read More »

KHN on the Air This Week

KHN Midwest correspondent Lauren Weber discussed COVID-19 surges in Wisconsin with Wisconsin Public Radio’s “Central Time” on Nov. 13. Click here to hear Weber on Wisconsin Public Radio California Healthline correspondent Angela Hart and editor Emily Bazar discussed how the Supreme Court case about the Affordable Care Act could affect California with the CalMatters and …

KHN on the Air This Week Read More »

Surprise Federal Drug Rule Directs Insurers to Reveal What They Pay for Prescription Drugs

Health insurance companies will have to give their customers estimated out-of-pocket costs for prescription drugs and disclose to the public the negotiated prices they pay for drugs, under an unexpected new Trump administration rule. The administration said those requirements, part of a broader rule issued Oct. 29 forcing health plans to disclose costs and payments …

Surprise Federal Drug Rule Directs Insurers to Reveal What They Pay for Prescription Drugs Read More »

‘An Arm and a Leg’: For Your Next Health Insurance Fight, an Exercise in Financial Self-Defense

Can’t see the audio player? Click here to listen. A listener asked: ‘How do I remain cool when calling insurance companies?” So we called veteran self-defense teacher Lauren Taylor for advice. She leads Defend Yourself, an organization that works to empower people against violence and abuse.  As Taylor teaches it, self-defense involves a lot more than …

‘An Arm and a Leg’: For Your Next Health Insurance Fight, an Exercise in Financial Self-Defense Read More »

KHN’s ‘What the Health?’: Transition Interrupted

Can’t see the audio player? Click here to listen on SoundCloud. Five days after the election was called for President-elect Joe Biden, President Donald Trump has not conceded — and instead ordered his administration not to begin the transition of power. That could have serious ramifications for health care, particularly as nearly every state is …

KHN’s ‘What the Health?’: Transition Interrupted Read More »

Workers Who Lost Jobs Due to COVID May Need Help Getting Coverage This Fall

Michelina Moen lost her job and health insurance in April. Only weeks earlier she had begun to feel ill and not her usual energetic self — in what she describes as a textbook case of “really bad timing.” The Orlando, Florida, resident sought treatment in May. After a series of tests, doctors told Moen she …

Workers Who Lost Jobs Due to COVID May Need Help Getting Coverage This Fall Read More »

Fiscal general de California: los jueces deben ver que ACA es “indispensable”

Sacramento.- Cuando la Corte Suprema de los Estados Unidos esté escuchando el martes 10 un caso que podría decidir el destino de la Ley de Cuidado de Salud a Bajo Precio (ACA), California liderará la defensa de la ley federal que impacta en casi todos los aspectos del sistema de salud del país. Por lo …

Fiscal general de California: los jueces deben ver que ACA es “indispensable” Read More »

Justices Bound to See ACA as ‘Indispensable,’ Says Californian Leading Defense

SACRAMENTO — When the U.S. Supreme Court hears a case Tuesday that could decide the fate of the Affordable Care Act, California will be leading the defense to uphold the federal law that touches nearly every aspect of the country’s health care system. It’s usually the federal government’s job to defend a federal law, but …

Justices Bound to See ACA as ‘Indispensable,’ Says Californian Leading Defense Read More »

Biden Wins, but His Health Agenda Dims With GOP Likely to Hold Senate

Former Vice President Joe Biden secured the 270 electoral votes needed to capture the White House on Saturday, major news organizations projected,  after election officials in a handful of swing states spent days in round-the-clock counting of millions of mail-in ballots and early votes. The Democrat’s victory came after the latest tallies showed him taking …

Biden Wins, but His Health Agenda Dims With GOP Likely to Hold Senate Read More »

KHN on the Air This Week

Columnist and California Healthline senior correspondent Bernard J. Wolfson discussed the start of open enrollment for health care plans in California with KPCC’s “Take Two” on Monday. Click here to hear Wolfson on KPCC Read Wolfson’s “It’s Open Enrollment. Here’s What You Need to Know.“ Kaiser Health News (KHN) is a national health policy news …

KHN on the Air This Week Read More »

Longtime Health Advocate Donna Shalala Loses House Reelection Race

Rep. Donna E. Shalala of Florida, the first-term Democratic member of Congress and former Health and Human Services secretary in the Clinton administration, lost her campaign for reelection Tuesday. Shalala’s loss to Maria Elvira Salazar — a Republican and former television journalist who compared Democratic policy proposals to leftist oppression in countries like Cuba while …

Longtime Health Advocate Donna Shalala Loses House Reelection Race Read More »

If They Sweep on Election Day, Dems Still Face a Challenge Meeting Health Promises

Democrats are favored to win both chambers of Congress after years of campaign-trail promises about health care. But with a pandemic, a more conservative Supreme Court and lingering disagreements between progressives and moderates, it could be difficult for Democrats to turn those promises into law. In the final days of the campaign, COVID-19 and the …

If They Sweep on Election Day, Dems Still Face a Challenge Meeting Health Promises Read More »

KHN’s ‘What the Health?’: As Cases Spike, White House Declares Pandemic Over

Can’t see the audio player? Click here to listen on SoundCloud. White House chief of staff Mark Meadows said this week that “we’re not going to control the pandemic,” effectively conceding that the administration has pivoted from prevention to treatment. But COVID-19 cases are rising rapidly in most of the nation, and the issue is playing …

KHN’s ‘What the Health?’: As Cases Spike, White House Declares Pandemic Over Read More »

A $10,000 Obamacare Penalty? Doubtful.

“Because our family couldn’t afford health insurance, Obama/Biden penalized us about $10,000, then took that $10,000 and used it to pay for others’ free Obamacare. Trump ended that theft.” In a Facebook post, Oct. 20, 2020 A viral Facebook post claims that former President Barack Obama’s health insurance law penalized a family a large amount …

A $10,000 Obamacare Penalty? Doubtful. Read More »

Sen. Graham Complains That 3 Blue States Get a Third of ACA Funding

Sen. Lindsey Graham has never been a fan of the Affordable Care Act — even though it’s helped dramatically lower the number of uninsured people in his home state of South Carolina. The Republican, who heads the Senate Judiciary Committee, attacked the law at the confirmation hearings for Supreme Court nominee Amy Coney Barrett. Democrats …

Sen. Graham Complains That 3 Blue States Get a Third of ACA Funding Read More »

Hospital Bills for Uninsured COVID Patients Are Covered, but No One Tells Them

When Darius Settles died from COVID-19 on the Fourth of July, his family and the city of Nashville, Tennessee, were shocked. Even the mayor noted the passing of a 30-year-old without any underlying conditions — one of the city’s youngest fatalities at that point. Settles was also uninsured and had just been sent home from …

Hospital Bills for Uninsured COVID Patients Are Covered, but No One Tells Them Read More »

App-Based Companies Pushing Prop. 22 Say Drivers Will Get Health Benefits. Will They?

App-based driving services such as Uber, Lyft, DoorDash and Instacart are bankrolling California’s Proposition 22, which would keep their drivers classified as independent contractors, not employees. Leading into the Nov. 3 election, the ballot measure — which has become the most expensive in state history — is mired in controversy and the subject of a …

App-Based Companies Pushing Prop. 22 Say Drivers Will Get Health Benefits. Will They? Read More »

The Trump Medicaid Record: Big Goals, Yet Few Successes

President Donald Trump entered office seeking a massive overhaul of the Medicaid program, which had just experienced the biggest growth spurt in its 50-year history. His administration supported repealing the Affordable Care Act’s Medicaid expansion, which has added millions of adults to the federal-state health program for lower-income Americans. He also wanted states to require …

The Trump Medicaid Record: Big Goals, Yet Few Successes Read More »

Savvy Patient Fought for the Price She Was Quoted − And Didn’t Give Up

When Tiffany Qiu heard how much her surgery was going to cost her, she was sure the hospital’s financial department had made a mistake. Qiu, who already knew from a breast cancer scare earlier that year that her plan required a 30% coinsurance payment on operations, pressed the person on the phone several times to …

Savvy Patient Fought for the Price She Was Quoted − And Didn’t Give Up Read More »

If Trump Wins, Don’t Hold Your Breath Waiting for That ACA Replacement Plan

If President Donald Trump wins reelection next week, it seems unlikely he will unveil the health plan he’s been promising since before his election in 2016. Still, other aspects of health care could be featured in his second-term agenda. Not having a replacement plan for the Affordable Care Act may be just fine with many …

If Trump Wins, Don’t Hold Your Breath Waiting for That ACA Replacement Plan Read More »

How Bind Benefits’ CEO will use $105M to upend the health insurance market

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 changing world.

Did Trump Confuse the Public Option With ‘Medicare for All’?

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 to do, which will basically be socialized medicine — you …

Did Trump Confuse the Public Option With ‘Medicare for All’? Read More »

In Tamer Debate, Trump and Biden Clash (Again) on President’s Pandemic Response

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 talk. There was also less interrupting. Trump said a COVID-19 …

In Tamer Debate, Trump and Biden Clash (Again) on President’s Pandemic Response Read More »

Even With ACA’s Fate in Flux, Open Enrollment Starts Soon. Here’s What’s New.

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 are not projecting much impact from the pandemic for their …

Even With ACA’s Fate in Flux, Open Enrollment Starts Soon. Here’s What’s New. Read More »

Job-Based Health Insurance Costs Are Up 4% This Year, 55% in Past Decade

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 this year toward family coverage, up from about $4,000 in …

Job-Based Health Insurance Costs Are Up 4% This Year, 55% in Past Decade Read More »

Does the Federal Health Information Privacy Law Protect President Trump?

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 is his viral load? The answers were elusive. Picture the …

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Refuge in the Storm? ACA’s Role as Safety Net Is Tested by COVID Recession

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 federal and private research groups, generally indicate that when the …

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Fighting for Patient Protections While Attacking ACA — Hard to Have It Both Ways

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 and cancer have become a focal point for candidates nationwide …

Fighting for Patient Protections While Attacking ACA — Hard to Have It Both Ways Read More »

KHN on the Air This Week

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 to listen to Chapter One. KHN chief Washington correspondent Julie …

KHN on the Air This Week Read More »

Biden’s in the Ballpark on How Many People Have Preexisting Conditions

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,” said former Vice President Joe Biden, the Democratic nominee, arguing …

Biden’s in the Ballpark on How Many People Have Preexisting Conditions Read More »

COVID + Influenza: éste es un buen año para vacunarse, aconsejan expertos

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 que las personas eviten vacunarse. Aunque a veces se considera …

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COVID + Influenza: This Is a Good Year to Get a Flu Shot, Experts Advise

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 incorrectly regarded as just another bad cold, flu also kills …

COVID + Influenza: This Is a Good Year to Get a Flu Shot, Experts Advise Read More »

Opposition to Obamacare Becomes Political Liability for GOP Incumbents

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 opponents over the health care law during the campaign and …

Opposition to Obamacare Becomes Political Liability for GOP Incumbents Read More »

KHN’s ‘What the Health?’ Replay: What’s at Stake When High Court Hears ACA Case

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 good opportunity to replay an episode from March, when the …

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Republican Convention, Day 1: A Campaign-Style Trump Speech and More

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 at PolitiFact found many to be either wrong, misleading, premature …

Republican Convention, Day 1: A Campaign-Style Trump Speech and More Read More »

Veteran’s Appendectomy Launches Excruciating Months-Long Battle Over Bill

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 in Salida, Colorado. After a CT scan, doctors told Harness …

Veteran’s Appendectomy Launches Excruciating Months-Long Battle Over Bill Read More »

Democratic Convention, Night 4: ‘Facts Over Fiction’ in Biden’s Speech

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 partners at PolitiFact examined a range of claims made by …

Democratic Convention, Night 4: ‘Facts Over Fiction’ in Biden’s Speech Read More »

KHN’s ‘What The Health?’: Democrats in Array (For Now)

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 on issues — this year they cannot chatter on live …

KHN’s ‘What The Health?’: Democrats in Array (For Now) Read More »

GOP Senate Ad Misrepresents Mont. Governor’s Stance on Rural Hospitals, Public Option

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 close. Medicare as we know it will change, replaced by …

GOP Senate Ad Misrepresents Mont. Governor’s Stance on Rural Hospitals, Public Option Read More »

‘Pennie’-Pinching States Take Over Obamacare Exchanges From Feds

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, has used the federal www.healthcare.gov website for people buying coverage …

‘Pennie’-Pinching States Take Over Obamacare Exchanges From Feds Read More »

Primary Care Doctors Look at Payment Overhaul After Pandemic Disruption

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 large Seattle-area company that owns his practice is reassessing its …

Primary Care Doctors Look at Payment Overhaul After Pandemic Disruption Read More »

Kaiser sees Q2 net income more than double to $4.5B

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 “market fluctuations.”

‘An Arm and a Leg’: Financial Self-Defense School Is Now in Session

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 no dealer will divulge. She got a health care executive …

‘An Arm and a Leg’: Financial Self-Defense School Is Now in Session Read More »

KHN’s ‘What the Health?’: Still Waiting for That Trump Health Plan

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 a program to help struggling rural hospitals. Meanwhile, the administration …

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Missouri Voters Approve Medicaid Expansion Despite GOP Resistance

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, 2021. Voters approved expansion by a margin of 6.5 percentage …

Missouri Voters Approve Medicaid Expansion Despite GOP Resistance Read More »

Covered California Announces Record-Low Rate Hike for 2021

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 statewide increase of 0.8% on coverage that started in January …

Covered California Announces Record-Low Rate Hike for 2021 Read More »

Don’t Count on Lower Premiums Despite Pandemic-Driven Boon for Insurers

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 beds and shut down operating rooms to prepare for an …

Don’t Count on Lower Premiums Despite Pandemic-Driven Boon for Insurers Read More »

Missourians to Vote on Medicaid Expansion as Crisis Leaves Millions Without Insurance

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 as planned until the national retailer that Organ worked for …

Missourians to Vote on Medicaid Expansion as Crisis Leaves Millions Without Insurance Read More »

Medi-Cal Agency’s New Head Wants to Tackle Disparities and Racism

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 38.9% of the population, according to data collected by the …

Medi-Cal Agency’s New Head Wants to Tackle Disparities and Racism Read More »

The COVID-19 Downturn Triggers Jump in Medicaid Enrollment

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 people was less than many analysts predicted. One possible factor …

The COVID-19 Downturn Triggers Jump in Medicaid Enrollment Read More »

Last Thing Patients Need During Pandemic: Being Last to Know a Doctor Left Network

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 office conveniently located a few blocks from where Koeppel works. …

Last Thing Patients Need During Pandemic: Being Last to Know a Doctor Left Network Read More »

With DACA Ruling, Did Supreme Court Grant Trump New Powers To Reshape Health Care?

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 plan, Trump told him to stay tuned. “We’re signing a …

With DACA Ruling, Did Supreme Court Grant Trump New Powers To Reshape Health Care? Read More »

Medicaid Mystery: Millions of Enrollees Haven’t Materialized in California

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 2 million additional people to sign up for the state’s …

Medicaid Mystery: Millions of Enrollees Haven’t Materialized in California Read More »

Another Problem on the Health Horizon: Medicare Is Running Out of Money

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 Americans out of work, fewer payroll taxes are rolling in …

Another Problem on the Health Horizon: Medicare Is Running Out of Money Read More »

Digital health startup Kaia hopes to win over insurers with results of back pain study

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 future.

Administration Eases Rules to Give Laid-Off Workers More Time to Sign Up for COBRA

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 because of a layoff or a reduction in their hours …

Administration Eases Rules to Give Laid-Off Workers More Time to Sign Up for COBRA Read More »

For COVID Tests, the Question of Who Pays Comes Down to Interpretation

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, with no out-of-pocket cost to Epstein. But her children’s pediatrician …

For COVID Tests, the Question of Who Pays Comes Down to Interpretation Read More »

Must-Reads of the Week

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 writer to start breezing, welcome to this week’s rundown brought …

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Azar Says Federal Law Had Preexisting Conditions Covered Before ACA. Not So Much.

“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 its guarantee of insurance coverage — at no greater cost …

Azar Says Federal Law Had Preexisting Conditions Covered Before ACA. Not So Much. Read More »