Federal Judge Halts Dreamers’ Brand-New Access to ACA Enrollment in 19 States
A federal judge in North Dakota has ruled in favor of 19 states that challenged a Biden administration rule allowing — for the first time — enrollment in Affordable Care Act coverage by people brought to the U.S. as children…
Journalists Dig Into Vaccine Debate and America’s Obesity Rates
KFF Health News senior correspondent Arthur Allen discussed the fragility of our vaccine infrastructure on The Atlantic’s “Radio Atlantic” on Dec. 5. Click here to hear Allen on “Radio Atlantic” Read Allen’s “Scientists Fear What’s Next for Public Health if…
Georgia’s Work Requirement Slows Processing of Applications for Medicaid, Food Stamps
ATLANTA — Deegant Adhvaryu completed his parents’ applications for Medicaid and food benefits in June. Then the waiting and frustration began. In July, his parents, Haresh and Nina Adhvaryu, received a letter saying their applications would be delayed, he said….
How Potential Medicaid Cuts Could Play Out in California
In 2017, the Republicans who controlled Congress tried mightily to slash federal spending on Medicaid, the government-funded health program covering low-income families and individuals. California, like other states, depends heavily on federal dollars to provide care for its poorest residents….
9 States Poised To End Coverage for Millions if Trump Cuts Medicaid Funding
Phil Galewitz, KFF Health News With Donald Trump’s return to the White House and Republicans taking full control of Congress in 2025, the Affordable Care Act’s Medicaid expansion is back on the chopping block. More than 3 million adults in…
A Toddler Got a Nasal Swab Test but Left Before Seeing a Doctor. The Bill was $445.
Ryan Wettstein Nauman was inconsolable one evening last December. After being put down for bed, the 3-year-old from Peoria, Illinois, just kept crying and crying and crying, and nothing would calm her down. Her mother, Maggi Wettstein, remembered fearing it…
Florida’s Deloitte-Run Computer System Cut Off New Moms Entitled to Medicaid
Daniel Chang and Samantha Liss In mid-May, Mandi Rokx had a 3-month-old baby and a letter from a Florida agency warning that they both would be cut from Medicaid, the health insurance program for people with low incomes or disabilities….
Efforts To Curb ACA Enrollment Fraud Face Real-World Test
The current Affordable Care Act open enrollment season is the first big test of new federal guardrails against fraud. The rules aim to head off unauthorized ACA plan enrollments or switches by rogue agents and entities looking to make money…
Dicen que los esfuerzos contra el fraude en ACA han dado resultados. Pero hay que estar alerta
Los cambios no autorizados en los planes médicos de la Ley de Cuidado de Salud a Bajo Precio (ACA) parecen haberse reducido en las últimas semanas: reguladores federales informaron que hay menos quejas de los consumidores. Los Centros de Servicios…
Anti-Fraud Efforts Meet Real-World Test During ACA Enrollment Period
Unauthorized switching of Affordable Care Act plans appears to have tapered off in recent weeks based on an almost one-third drop in casework associated with consumer complaints, say federal regulators. The Centers for Medicare & Medicaid Services, which oversees the…
Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits
Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human…
TV’s Dr. Oz Invested in Businesses Regulated by Agency Trump Wants Him To Lead
Darius Tahir President-elect Donald Trump’s choice to run the sprawling government agency that administers Medicare, Medicaid, and the Affordable Care Act marketplace — celebrity doctor Mehmet Oz — recently held broad investments in health care, tech, and food companies that…
Washington Power Has Shifted. Here’s How the ACA May Shift, Too.
President-elect Donald Trump’s return to the White House could embolden Republicans who want to weaken or repeal the Affordable Care Act, but implementing such sweeping changes would still require overcoming procedural and political hurdles. Trump, long an ACA opponent, expressed…
Journalists Examine Health Care for Native Americans and Recent Food Recalls
Thank you for your interest in supporting Kaiser Health News (KHN), the nation’s leading nonprofit newsroom focused on health and health policy. We distribute our journalism for free and without advertising through media partners of all sizes and in communities…
Pay First, Deliver Later: Some Women Are Being Asked To Prepay for Their Baby
In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39,…
Readying for Republican Rule – KFF Health News
The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is…
KFF Health News Sues To Force Disclosure of Medicare Advantage Audit Records
Fred Schulte, KFF Health News KFF Health News has sued the U.S. Department of Health and Human Services Office of Inspector General to compel it to release a range of Medicare Advantage health plan audits and other financial records. The…
California amplió el Medi-Cal a todos los residentes más allá de su estatus migratorio. Los resultados son desiguales.
Este año, California ha dado el último paso para abrir el Medi-Cal, su programa de Medicaid, a todos los residentes que reúnan los requisitos, independientemente de su estatus migratorio. Es una expansión significativa para un programa de protección social que…
California Expanded Medi-Cal to Unauthorized Residents. The Results Are Mixed.
California this year took the final step in opening Medi-Cal, its Medicaid program, to every eligible resident regardless of immigration status. It’s a significant expansion for an already massive safety net program. Medi-Cal’s annual spending now stands at $157 billion,…
Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits
A new federal watchdog audit is ratcheting up pressure on government officials to crack down on billions of dollars in overcharges linked to Medicare Advantage home visits. But so far, the Centers for Medicare & Medicaid Services has rejected a…
In Vermont, Where Almost Everyone Has Insurance, Many Can’t Find or Afford Care
RICHMOND, Vt. — On a warm autumn morning, Roger Brown walked through a grove of towering trees whose sap fuels his maple syrup business. He was checking for damage after recent flooding. But these days, his workers’ health worries him…
Trump’s White House Return Poised To Tangle Health Care Safety Net
Former President Donald Trump’s election victory and looming return to the White House will likely bring changes that scale back the nation’s public health insurance programs — increasing the uninsured rate, while imposing new barriers to abortion and other reproductive…
El regreso de Trump a la Casa Blanca pondría en peligro la red de seguridad de atención médica
El triunfo electoral del ex presidente Donald Trump y su regreso a la Casa Blanca probablemente traerán cambios que reducirían los programas nacionales de salud públicos, aumentando la tasa de personas sin seguro e imponiendo nuevas barreras al aborto y…
Election Outcome Could Bring Big Changes to Medicare
On the campaign trail, both former President Donald Trump and Vice President Kamala Harris are eager to portray themselves as guardians of Medicare. Each presidential candidate accuses the other of backing spending cuts and other policies that would damage the…
Trump quiere que Harris pague un precio político por ofrecer salud a inmigrantes sin papeles
Joanne Kenen María Sánchez emigró al área de Chicago desde México hace unos 30 años. Ahora, a sus 87, sigue viviendo en Estados Unidos sin papeles. Como muchos inmigrantes de larga data, ha trabajado —y pagado impuestos, incluyendo para Medicare—…
What’s at Stake: A Pivotal Election for Six Big Health Issues
In the final days of the campaign, stark disagreements between Vice President Kamala Harris and former President Donald Trump over the future of American health care are on display — in particular, in sober warnings about abortion access, the specter…
Trump Wants Harris To Pay a Political Price for Generous Immigrant Health Policies
Joanne Kenen Maria Sanchez immigrated to the Chicago area from Mexico about 30 years ago. Now 87, she’s still living in the U.S. without authorization. Like many longtime immigrants, she has worked — and paid taxes, including Medicare taxes —…
In Montana, Conservative Groups See Chance To Kill Medicaid Expansion
Conservative groups are working to undermine support for Montana’s Medicaid expansion in hopes the state will abandon the program. The rollback would be the first in the decade since the Affordable Care Act began allowing states to cover more people…
A Rules Change Would Open the ACA to ‘Dreamers’
It’s that time of year again: open enrollment for Affordable Care Act insurance — a period that runs from tomorrow to Jan. 15 in most states, a bit longer in some, and shorter in Idaho. One of the biggest changes…
For People With Opioid Addiction, Medicaid ‘Unwinding’ Raises the Stakes
Kim Krisberg, Public Health Watch and Stephanie Colombini, WUSF CITRUS COUNTY, Fla. — It was hard enough for Stephanie to get methadone treatment when she moved to Florida from Indiana last year. The nearest clinic was almost an hour’s drive…
Toddler’s Backyard Snakebite Bills Totaled More Than a Quarter Million Dollars
This spring, a few days after his 2nd birthday, Brigland Pfeffer was playing with his siblings in their San Diego backyard. His mother, Lindsay Pfeffer, was a few feet away when Brigland made a noise and came running from the…
Ahora los “Dreamers” pueden inscribirse en planes de salud de ACA. Pero una demanda podría acabar con el sueño
Julie Appleby, KFF Health News Cuando comience el período de inscripción abierta para adquirir cobertura médica en los mercados de seguros establecidos por la Ley de Cuidado de Salud a Bajo Precio, conocida como Obamacare, un grupo que antes no…
‘Dreamers’ Can Enroll in ACA Plans This Year — But a Court Challenge Could Get in the Way
Julie Appleby, KFF Health News When open enrollment for the Affordable Care Act, or Obamacare, starts nationwide this week, a group that had previously been barred from signing up will be eligible for the first time: The “Dreamers.” That’s the…
Black Americans Still Suffer Worse Health. Here’s Why There’s So Little Progress.
Fred Clasen-Kelly and Renuka Rayasam KINGSTREE, S.C. — One morning in late April, a small brick health clinic along the Thurgood Marshall Highway bustled with patients. There was Joshua McCray, 69, a public bus driver who, four years after catching…
Presidential Election Puts Affordable Care Act Back in the Bull’s-Eye
Health care is suddenly front and center in the final sprint to the presidential election, and the outcome will shape the Affordable Care Act and the coverage it gives to more than 40 million people. Besides reproductive rights, health care…
Voters Fret High Medical Bills Are Being Ignored by Presidential Rivals
Tom Zawierucha, 58, a building services worker in New Jersey, wishes candidates would talk more about protecting older Americans from big medical bills. Teresa Morton, 43, a freight dispatcher in Memphis, Tennessee, with two teenagers, wants to hear more about…
PBM Math: Big Chains Are Paid $23.55 To Fill a Blood Pressure Rx. Small Drugstores? $1.51.
CUTHBERT, Ga. — While customers at Adams Family Pharmacy picked up their prescriptions on a hot summer day, some stopped in for coffee, ice cream, homemade cake, or cookies. It wasn’t a bake sale, but the sweets bring extra revenue…
Beneficiarios de Medicare gastarán menos en medicamentos en 2025
Cuando Pam McClure se enteró que el próximo año ahorraría casi $4,000 en sus medicamentos recetados dijo: “parece demasiado bueno para ser verdad”. Para finales de 2024, habrá gastado casi $6,000 en estos fármacos, incluido uno para controlar su diabetes….
Medicare Drug Plans Are Getting Better Next Year. Some Will Also Cost More.
When Pam McClure learned she’d save nearly $4,000 on her prescription drugs next year, she said, “it sounded too good to be true.” She and her husband are both retired and live on a “very strict” budget in central North…
California Continues Progressive Policies, With Restraint, in Divisive Election Year
Don Thompson SACRAMENTO, Calif. — This year, Gov. Gavin Newsom affirmed abortion access, calling California “a proud reproductive freedom state” and criticizing Republicans across the country for trying to take away families’ rights. He signed legislation mandating that insurance companies…
LIVE From KFF: Health Care and the 2024 Election
The Host The 2024 campaign — particularly the one for president — has been notably vague on policy. But health issues, especially those surrounding abortion and other reproductive health care, have nonetheless played a key role. And while the Affordable…
Harris Backs Slashing Medical Debt. Trump’s ‘Concepts’ Worry Advocates.
Noam N. Levey Patient and consumer advocates are looking to Kamala Harris to accelerate federal efforts to help people struggling with medical debt if she prevails in next month’s presidential election. And they see the vice president and Democratic nominee…
Harris apoya la reducción de la deuda médica. Los “conceptos” de Trump preocupan a defensores.
Defensores de pacientes y consumidores confían en que Kamala Harris acelere los esfuerzos federales para ayudar a las personas que luchan con deudas médicas, si gana en las elecciones presidenciales del próximo mes. Y ven a la vicepresidenta y candidata…
Yet Another Promise for Long-Term Care Coverage
The Host As part of a media blitz aimed at women voters, Vice President Kamala Harris this week rolled out a plan for Medicare to provide in-home long-term care services. It’s popular, particularly for families struggling to care for both…
Montana Looks To Fast-Track Medicaid Access for Older Applicants
Montana lawmakers are looking to fast-track Medicaid coverage for older adults who need help with daily life. LISTEN here: Montana is looking to fast-track Medicaid access for older adults who need help to stay in their homes or towns. Medicaid,…
Employers Haven’t a Clue How Their Drug Benefits Are Managed
Arthur Allen Most employers have little idea what the pharmacy benefit managers they hire do with the money they exchange for the medications used by their employees, according to a KFF survey released Wednesday morning. In KFF’s latest employer health…
What’s New and What To Watch For in the Upcoming ACA Open Enrollment Period
It’s that time of year again: In most states, the Affordable Care Act’s annual open enrollment season for health plans begins Nov. 1 and lasts through Jan. 15. Current enrollees who do not update their information or select an alternative…
Lo nuevo y lo que debes tener en cuenta en el próximo período de inscripción abierta de ACA
Estamos en esa época del año otra vez. En la mayoría de los estados, la temporada de inscripción abierta de la Ley de Cuidado de Salud a Bajo Precio (ACA) para los planes de salud comienza el 1 de noviembre…
The Health of the Campaign
The Host When it comes to health care, this year’s presidential campaign is increasingly a matter of which candidate voters choose to believe. Democrats, led by Vice President Kamala Harris, say Republicans want to further restrict reproductive rights and repeal…
Amid Medicaid ‘Unwinding,’ Many States Wind Up Expanding
It was expected that the past year and a half would be a fraught time for Medicaid, the workhorse of the nation’s health system, which covers more people than any other government health insurance program. In April 2023, states resumed…
Harris Correct That Trump Fell Short on Promise To Negotiate Medicare Drug Prices
Jacob Gardenswartz “Donald Trump said he was going to allow Medicare to negotiate drug prices. He never did. We did.” Vice President Kamala Harris at the ABC News presidential debate, Sept. 10 Since Vice President Kamala Harris entered the presidential…
Vance-Walz Debate Highlighted Clear Health Policy Differences
KFF Health News and PolitiFact staffs Ohio Republican Sen. JD Vance and Minnesota Democratic Gov. Tim Walz met in an Oct. 1 vice presidential debate hosted by CBS News that was cordial and heavy on policy discussion — a striking change from…
Benefit Trend: Employers Opt To Give Workers an Allowance for Coverage
Dave Lantz is no stranger to emergency department or doctor bills. With three kids in their teens and early 20s, “when someone gets sick or breaks an arm, all of a sudden you have thousand-dollar medical bills,” Lantz said. The…
The Medicare Advantage Influence Machine
Federal officials resolved more than a decade ago to crack down on whopping government overpayments to private Medicare Advantage health insurance plans, which were siphoning off billions of tax dollars every year. But Centers for Medicare & Medicaid Services officials…
Journalists Weigh In on Racial Trauma, Medicaid Expansion, and Opioid Settlements
KFF Health News Midwest correspondent Cara Anthony discussed healing from racial trauma on “America’s Heroes Group” on Sept. 20. Click here to watch Anthony on “America’s Heroes Group” Explore Anthony’s series on the topic, “Silence in Sikeston” KFF Health News…
In Chronic Pain, This Teenager ‘Could Barely Do Anything.’ Insurer Wouldn’t Cover Surgery.
When Preston Nafz was 12, he asked his dad for permission to play lacrosse. “First practice, he came back, he said, ‘Dad, I love it,’” recalled his father, Lothar Nafz, of Hoover, Alabama. “He lives for lacrosse.” But years of…
Vance Rewrites History About Trump and Obamacare
Julie Appleby, KFF Health News Donald Trump could have destroyed the Affordable Care Act, but “he chose to build upon [it].” Sen. JD Vance (R-Ohio) on “Meet the Press,” Sept. 15 Sen. JD Vance (R-Ohio) on Sept. 15 told viewers…
These Alabama Workers Were Swamped by Medical Debt. Then Their Employer Stepped In.
Noam N. Levey TUSCALOOSA, Ala. — Like most medical offices, the small suite of exam rooms at the PhiferCares Clinic fills daily with patients seeking help with bumps and bruises, sore throats, and stuffy noses. But there’s an important difference…
California Medicaid Ballot Measure Is Popular, Well Funded — And Perilous, Opponents Warn
The proponents of Proposition 35, a November ballot initiative that would create a dedicated stream of funding to provide health care for California’s low-income residents, have assembled an impressive coalition: doctors, hospitals, community clinics, dentists, ambulance companies, several county governments,…
Arkansas’ Governor Says Medicaid Extension for New Moms Isn’t Needed
Six weeks after an emergency cesarean section, with her newborn twins still in neonatal intensive care, Maya Gobara went to a pharmacy in West Little Rock, Arkansas, to fill a prescription. “The pharmacy told me I didn’t have insurance,” Gobara…
California May Regulate and Restrict Pharmaceutical Brokers
SACRAMENTO, Calif. — California Gov. Gavin Newsom will soon decide whether the most populous U.S. state will join 25 others in regulating the middlemen known as pharmacy benefit managers, or PBMs, whom many policymakers blame for the soaring cost of…
Tossed Medicine, Delayed Housing: How Homeless Sweeps Are Thwarting Medicaid’s Goals
SAN FRANCISCO — Andrew Douglass shoved his clothes and belongings into plastic trash bags as five police officers surrounded his encampment — a drab gray tent overflowing along a bustling sidewalk in the gritty Tenderloin neighborhood, where homeless people lie…
The First Year of Georgia’s Medicaid Work Requirement Is Mired in Red Tape
ATLANTA — On a recent summer evening, Raymia Taylor wandered into a recreation center in a historical downtown neighborhood, the only enrollee to attend a nearly two-hour event for people who have signed up for Georgia’s experimental Medicaid expansion. The…
‘What Happens Three Months From Now?’ Mental Health After Georgia High School Shooting
WINDER, Ga. — About an hour after gunfire erupted at Apalachee High School, ambulances started arriving at nearby Northeast Georgia Medical Center Barrow with two students and two adults suffering from panic attacks and extreme anxiety, not bullet wounds. A…
Forget Repeal and Replace. The Next Big ACA Fight Will Be Over Subsidies.
Forget repeal and replace. Critics of the Affordable Care Act, a.k.a. Obamacare, have a new target: key parts of the law that they say are too costly and provide incentive for fraud. Topping that list are the ACA’s enhanced subsidies, put…
En su primer cara a cara, Harris y Trump se enfrentan por el Obamacare y el aborto
KFF Health News and PolitiFact staffs Cuando la vicepresidenta Kamala Harris cruzó el escenario del debate el martes 10 por la noche para darle la mano al ex presidente Donald Trump, fue la primera vez que los dos se conocían…
Trump, Harris Spar Over Abortion Rights and Obamacare in Their First Face-Off
KFF Health News and PolitiFact staffs When Vice President Kamala Harris walked across the debate stage Tuesday night to shake the hand of former President Donald Trump, it was the first time the two had met in person. But that…
Longtime Head of L.A. Care To Retire After Navigating Major Medi-Cal Changes
LOS ANGELES — For nearly a decade, John Baackes has led L.A. Care Health Plan, a publicly run insurer primarily serving low-income Los Angeles County residents on Medi-Cal. It is by far the largest Medi-Cal plan in the state. Baackes,…
US Uninsured Rate Was Stable in 2023, Even as States’ Medicaid Purge Began
The proportion of Americans without health insurance remained stable in 2023, the Census Bureau reported Tuesday, close to the record low the Biden administration achieved in 2022 through expansions of public programs, including the Affordable Care Act. About 8% of…
ACA Enrollment Platforms Suspended Over Alleged Foreign Access to Consumer Data
Suspicions that U.S. consumers’ personal information could be accessed from India led regulators to abruptly bar two large private sector enrollment websites from accessing the Affordable Care Act marketplace in August. New details about the suspensions come in legal filings…
Errors in Deloitte-Run Medicaid Systems Can Cost Millions and Take Years To Fix
The computer systems run by the consulting giant Deloitte that millions of Americans rely on for Medicaid and other government benefits are prone to errors that can take years and hundreds of millions of dollars to update. While states wait…
Cuando la aseguradora se niega a pagar un aborto que es médicamente necesario
A principios de 2022, Ashley y Kyle estaban recién casados, y emocionados porque esperaban su primer hijo. Pero desde el comienzo de su embarazo, Ashley había tenido hemorragias, y en julio, a las siete semanas, comenzó a tener un aborto…
Para las farmacéuticas, la pelea entre Trump y Harris es entre dos enemigos de la industria
En medio de una amarga y divisiva contienda, el ex presidente Donald Trump y la vicepresidenta Kamala Harris solo parecen coincidir en una cosa: es tarea del gobierno reducir los altos precios de los medicamentos en el país. En 2022,…
Her Life Was at Risk. She Needed an Abortion. Insurance Refused To Pay.
Sarah Varney, KFF Health News Ashley and Kyle were newlyweds in early 2022 and thrilled to be expecting their first child. But bleeding had plagued Ashley from the beginning of her pregnancy, and in July, at seven weeks, she began…
Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition
A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars — only to abruptly back off amid an “uproar” from the industry, newly released court filings show. The…
Don’t Get ‘Bullied’ Into Paying What You Don’t Owe
Dan Weissmann Caitlyn Mai thought she did everything right. She called ahead to make sure her insurer would cover her cochlear implant surgery. She thought everything went according to plan but she still got a bill for the full cost…
For Pharma, Trump vs. Harris Is a Showdown Between Two Industry Foes
Former President Donald Trump and Vice President Kamala Harris have a rare point of agreement in their otherwise bitter and divisive contest: It’s up to the government to cut high U.S. drug prices. Harris cast the tie-breaking Senate vote in…
Turning 26 and Struggling To Find Health Insurance? Tell Us About It.
Elisabeth Rosenthal A hard-won provision of the Affordable Care Act allows young adults to stay on their family’s health insurance until age 26. But after that, those without employer-sponsored insurance face an array of complicated choices, including whether to shop…
Journalists Talk Shooting’s Toll on Children and State Handling of Opioid Settlement Funds
KFF Health News Midwest correspondent Bram Sable-Smith discussed the enduring trauma experienced by children who survived the Super Bowl parade shooting earlier this year on KMOX’s “Total Information AM” on Aug. 22. Click here to hear Sable-Smith on “Total Information…
Biden Administration Blocks Two Private Sector Enrollment Sites From ACA Marketplace
Federal regulators have blocked two private sector enrollment websites from accessing consumer information through the federal Obamacare marketplace, citing “anomalous activity.” The unusual step comes as the Centers for Medicare & Medicaid Services is under the gun to curb unauthorized…
Patient Underwent One Surgery but Was Billed for Two. Even After Being Sued, She Refused To Pay.
Jamie Holmes says a surgery center tried to make her pay for two operations after she underwent only one. She refused to buckle, even after a collection agency sued her last winter. Holmes, who lives in northwestern Washington state, had…
Harris Did Not Vote to ‘Cut Medicare,’ Despite Trump’s Claim
Jacob Gardenswartz “As vice president, Kamala Harris cast the tie-breaking vote to cut, as you know, Medicare by $273 billion. She cast a vote to cut Medicare.” — Former President Donald Trump at a July 24 campaign rally in Charlotte,…
Amid Medicaid ‘Unwinding,’ Many States Wind Up Expanding
Trisha Byers left behind one crucial item when she moved to North Carolina last year to be closer to her family after suffering a brain injury: health insurance. In Massachusetts, Byers, 39, was enrolled in Medicaid, the government health program…
Happy 50th, ERISA – KFF Health News
The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is…
New Lines of Attack Form Against the Affordable Care Act
The Affordable Care Act is back under attack. Not as in the repeal-and-replace debates of yore, but in a fresher take from Republican lawmakers who say key parts of the ACA cost taxpayers too much and provide incentive for fraud….
Medi-Cal’s Dental Care Gap: Getting a Tooth Pulled Is Easy — Much Harder To Get an Implant
SAN RAFAEL, Calif. — When Bobby Moske went to a community clinic a few years ago with a toothache, he couldn’t find a dentist in Marin County willing to take Medicaid to do a root canal. Marin Community Clinics referred…
The Politics Holding Back Medicaid Expansion in Some Southern States
For Roderick Givens, a radiation oncologist, the expansion of Medicaid isn’t just a policy issue. He practices medicine in a rural area in the Mississippi Delta and he sees daily how Medicaid coverage could help his uninsured patients. “I can’t…
GOP Charge That Harris Backed Taxpayer-Funded Care for All Immigrants Overlooks Details
Stephanie Armour Vice President Kamala Harris “endorsed free taxpayer-funded government health care for all illegal aliens.” Former President Donald Trump, July 24, in a speech at a rally in Charlotte, North Carolina. Attacking Vice President Kamala Harris on immigration, Republicans…
Union With Labor Dispute of Its Own Threatens to Cut Off Workers’ Health Benefits
The National Education Association, the nation’s largest union, is threatening to cut off health insurance to about 300 Washington, D.C.-based workers on Aug. 1 in an effort to end a bitter contract dispute. It’s a tactic some private employers have…
Oregon Senator Proposes Criminal Charges and Fines for Rogue Obamacare Agents
Julie Appleby, KFF Health News Health insurance agents who fraudulently enroll consumers in Affordable Care Act health plans could be subject to criminal charges — and civil penalties of $10,000 to $200,000 — under legislation introduced Wednesday by Sen. Ron…
Harris, Once Biden’s Voice on Abortion, Would Take an Outspoken Approach to Health
Throughout Joe Biden’s presidency, he leaned on the outspoken former prosecutor and senator he selected as his vice president, Kamala Harris, to be the White House’s voice of unflinching support for reproductive health rights. Now, as Democrats rebuild their presidential…
Harris, alguna vez la voz de Biden sobre el aborto, tendría un enfoque abierto en temas de salud
A lo largo de su presidencia, Joe Biden se apoyó en Kamala Harris, la ex fiscal y senadora frontal que eligió como vicepresidenta, para ser la voz de apoyo inquebrantable de la Casa Blanca en favor de los derechos de…
Misleading Ads Play Key Role in Schemes to Gin Up Unauthorized ACA Sign-Ups, Lawsuit Alleges
The government is giving away money! So say ads on a variety of social media platforms. Consumers, the ads claim, can qualify for $1,400 or even $6,400 a month to use on groceries, rent, medical expenses, and other bills. Some…
At Trump’s GOP Convention, There’s Little To Be Heard on Health Care
No talk of Obamacare. Or abortion. At the Republican National Convention in Milwaukee this week, where delegates officially nominated Donald Trump as the party’s 2024 presidential candidate, health care issues received little attention from prime-time speakers. The silence is surprising,…
Biden Administration Tightens Broker Access to Healthcare.gov To Thwart Rogue Sign-Ups
Julie Appleby, KFF Health News The Biden administration on Friday put in place stringent curbs aimed at thwarting rogue insurance brokers from switching consumers’ Affordable Care Act plans without their consent. The announcement came in response to mounting complaints from…
En la convención republicana de Trump se escuchó poco y nada sobre atención de salud
Ni una palabra sobre el Obamacare o el aborto. En la Convención Nacional Republicana en Milwaukee esta semana, donde los delegados nominaron oficialmente a Donald Trump como candidato presidencial del partido para 2024, los oradores principales le dieron poco lugar…
Her Hearing Implant Was Preapproved. Nonetheless, She Got $139,000 Bills for Months.
Caitlyn Mai woke up one morning in middle school so dizzy she couldn’t stand and deaf in one ear, the result of an infection that affected one of her cranial nerves. Though her balance recovered, the hearing never came back….
The Woman Who Beat an $8,000 Hospital Fee
Dan Weissmann Hospital facility fees. They can feel like a charge just for walking in the door. Hospitals say they go toward overhead on facilities with lots of specialized equipment and staff, like emergency rooms. But these fees have grown…
HealthSherpa and Insurers Team Up To Curb Unauthorized ACA Enrollment Schemes
The largest private company that brokers use to enroll people in Affordable Care Act health plans said it’s joining with insurers to thwart unauthorized Obamacare sign-ups and plan switches. HealthSherpa, which has its own sales team, announced the new initiative…
California Health Care Pioneer Goes National, Girds for Partisan Skirmishes
SACRAMENTO — When then-Gov. Arnold Schwarzenegger called for nearly all Californians to buy health insurance or face a penalty, Anthony Wright slammed the 2007 proposal as “unwarranted, unworkable, and unwise” — one that would punish those who could least afford…
‘A Bottomless Pit’: How Out-of-Pocket TMJ Costs Drive Patients Into Debt
Over three decades of relentless pain, Jonna Tallant has tried about every TMJ treatment: mouthguards, six sets of braces, dental crowns and appliances, drugs, physical therapy, Botox, massage, acupuncture, chiropractic care, and surgery. Nothing has helped. Tallant, 51, of Knoxville,…
If Lawsuit Ends Federal Mandates on Birth Control Coverage, States Will Have the Say
David Engler had been pretty sure he didn’t want children. Then a frustrating school day two years ago helped seal the deal for the now 43-year-old substitute teacher. “It was wild. I had to call the office seven times to…
Lack of Affordability Tops Older Americans’ List of Health Care Worries
What weighs most heavily on older adults’ minds when it comes to health care? The cost of services and therapies, and their ability to pay. “It’s on our minds a whole lot because of our age and because everything keeps…
Meet the Middleman’s Middleman – KFF Health News
Dan Weissmann Some people who expected their health insurance to cover some out-of-network care have been getting stuck with enormous bills. One Kansas City, Kansas, couple paid thousands of dollars out-of-pocket and up-front for care. They expected to get a…
How Two States Reveal a Deeper Divide on Insuring Kids’ Health
Arizona and Florida lawmakers saw trouble ahead for children in 2023, with states slated — as the covid-19 pandemic waned — to resume disenrolling ineligible people from Medicaid. So, legislators in both states voted to expand a safety net known…
Sobrevivientes del tiroteo en el desfile de los Chiefs esperan las donaciones prometidas mientras acumulan cuentas médicas
Abigail Arellano tiene todas las facturas médicas de su hijo Samuel en una carpeta azul en un armario arriba del microondas. Incluso ahora, cuatro meses después que el niño de 11 años fuera herido de bala en el desfile del…
Journalists Discuss Bird Flu, Tick-Borne Illnesses, and Lessons From Covid Response
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Live From Aspen: Health and the 2024 Elections
The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is…
Super Bowl Parade Shooting Survivors Await Promised Donations While Bills Pile Up
Abigail Arellano keeps her son Samuel’s medical bills in a blue folder in a cabinet above the microwave. Even now, four months after the 11-year-old was shot at the Kansas City Chiefs Super Bowl parade, the bills keep coming. There’s…
California Leaders Tussle With Health Industry Over Billions of New Dollars for Medi-Cal
Gov. Gavin Newsom, state lawmakers, and health industry leaders have a small window to reach an agreement on billions of new dollars for Medi-Cal before it’s put to voters in November. An initiative, supported by virtually every sector of the…
A Tale of Two States: Arizona and Florida Diverge on How To Expand Kids’ Health Insurance
Arizona and Florida — whose rates of uninsured children are among the highest in the nation — set goals last year to widen the safety net that provides health insurance to people 18 and younger. But their plans to expand…
Biden’s on Target About What Repealing ACA Would Mean for Preexisting Condition Protections
Jacob Gardenswartz If the Affordable Care Act were terminated, “that would mean over a hundred million Americans will lose protections for preexisting conditions.” President Joe Biden in a campaign advertisement, May 8 President Joe Biden’s reelection campaign wants voters to…
Biden Plan to Save Medicare Patients Money on Drugs Risks Empty Shelves, Pharmacists Say
Months into a new Biden administration policy intended to lower drug costs for Medicare patients, independent pharmacists say they’re struggling to afford to keep some prescription drugs in stock. “It would not matter if the governor himself walked in and…
Journalists Discuss Abortion Laws, Pollution, and Potential Changes to Obamacare Subsidies
KFF Health News senior fellow and editor-at-large for public health Céline Gounder discussed the consequences of restrictive and unclear abortion laws on CBS’ “CBS Mornings” on June 4. Gounder also discussed a recent report that found pollution is a greater…
California Becomes Latest State To Try Capping Health Care Spending
Bernard J. Wolfson California’s Office of Health Care Affordability faces a herculean task in its plan to slow runaway health care spending. The goal of the agency, established in 2022, is to make care more affordable and accessible while improving…
Medicaid Recipients Struggle To Stay Enrolled
Dan Weissmann Medicaid — the state-federal health insurance program for low-income and disabled Americans — has cut more than 22 million recipients since spring 2023. One of them was the son of Ashley Eades. Her family lost their Medicaid coverage…
Presidential Election Could Decide Fate of Extra Obamacare Subsidies
When Cassie Cox ended up in the emergency room in January, the Bainbridge, Georgia, resident was grateful for the Obamacare insurance policy she had recently selected for coverage in 2024. Cox, 40, qualified for an Affordable Care Act marketplace plan…
Wyden Demands Penalties for Obamacare Enrollment Fraud
Lawmakers and state officials are turning up the heat on federal regulators to stop unscrupulous, commission-hungry insurance agents from enrolling thousands of people in Affordable Care Act plans, or switching their coverage, without their knowledge. Customers often don’t discover the…
Anti-Abortion Hard-Liners Speak Up – KFF Health News
The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is…
California Pays Meth Users To Get Sober
GRASS VALLEY, Calif. — Here in the rugged foothills of California’s Sierra Nevada, the streets aren’t littered with needles and dealers aren’t hustling drugs on the corner. But meth is almost as easy to come by as a hazy IPA…
He Fell Ill on a Cruise. Before He Boarded the Rescue Boat, They Handed Him the Bill.
Vincent Wasney and his fiancée, Sarah Eberlein, had never visited the ocean. They’d never even been on a plane. But when they bought their first home in Saginaw, Michigan, in 2018, their real estate agent gifted them tickets for a…
Biden Leans Into Health Care, Asking Voters To Trust Him Over Trump
Angling to tap into strong support for the sweeping health law he helped pass 14 years ago, one of President Joe Biden’s latest reelection strategies is to remind voters that former President Donald Trump tried to repeal the Affordable Care…
Senator Urges Biden Administration To Thwart Fraudulent Obamacare Enrollments
Stronger actions are needed immediately to thwart insurance brokers who fraudulently enroll or switch people in Affordable Care Act coverage, Sen. Ron Wyden, chairman of the powerful Senate Finance Committee, said Monday. “We want the Centers for Medicare & Medicaid…
Medicaid Unwinding Deals Blow to Tenuous System of Care for Native Americans
About a year into the process of redetermining Medicaid eligibility after the covid-19 public health emergency, more than 20 million people have been kicked off the joint federal-state program for low-income families. A chorus of stories recount the ways the…
California’s $12 Billion Medicaid Makeover Banks on Nonprofits’ Buy-In
TURLOCK, Calif. — For much of his young life, Jorge Sanchez regularly gasped for air, at times coughing so violently that he’d almost throw up. His mother whisked him to the emergency room late at night and slept with him…
Medicaid ‘Unwinding’ Decried as Biased Against Disabled People
Jacqueline Saa has a genetic condition that leaves her unable to stand and walk on her own or hold a job. Every weekday for four years, Saa, 43, has relied on a home health aide to help her cook, bathe…
Why Medicaid’s ‘Undercount’ Problem Counts
Millions of people were surprised to find themselves booted from Medicaid over the past year after pandemic-era protections expired that had prevented states from terminating their coverage. Turns out, millions of them were also unaware they had been covered by…
Newly Minted Doctors Are Avoiding Abortion Ban States
The Host A new analysis finds that graduating medical students were less likely to apply this year for residency training in states that ban or restrict abortion. That was true not only for aspiring OB-GYNs and others who regularly treat…
Biden Team’s Tightrope: Reining In Rogue Obamacare Agents Without Slowing Enrollment
President Joe Biden counts among his accomplishments the record-high number of people, more than 21 million, who enrolled in Obamacare plans this year. Behind the scenes, however, federal regulators are contending with a problem that affects people’s coverage: rogue brokers…
California propone ampliar subsidios de seguros de salud a todos los inmigrantes adultos
Marisol Pantoja Toribio se encontró un bulto en el pecho a principios de enero. Sin seguro y viviendo en California sin papeles, y sin su familia, la normalmente despreocupada mujer de 43 años se dio cuenta pronto de lo limitadas…
California Floats Extending Health Insurance Subsidies to All Adult Immigrants
Marisol Pantoja Toribio found a lump in her breast in early January. Uninsured and living in California without legal status and without her family, the usually happy-go-lucky 43-year-old quickly realized how limited her options were. “I said, ‘What am I…
AC, Power Banks, Mini Fridges: Oregon Equips Medicaid Patients for Climate Change
Samantha Young Oregon is shipping air conditioners, air purifiers, and power banks to some of its most vulnerable residents, a first-in-the-nation experiment to use Medicaid money to prevent the potentially deadly health effects of extreme heat, wildfire smoke, and other…
Sign Here? Financial Agreements May Leave Doctors in the Driver’s Seat
Cass Smith-Collins jumped through hoops to get the surgery that would match his chest to his gender. Living in Las Vegas and then 50, he finally felt safe enough to come out as a transgender man. He had his wife’s…
Millions Were Booted From Medicaid. The Insurers That Run It Gained Medicaid Revenue Anyway.
Private Medicaid health plans lost millions of members in the past year as pandemic protections that prohibited states from dropping anyone from the government program expired. But despite Medicaid’s unwinding, as it’s known, at least two of the five largest…
Whatever Happened to Biden’s Public Option?
In the 2020 elections, then-candidate Joe Biden and many of his congressional colleagues loudly advocated for a federal “public option” health insurance plan. It was framed, at the time, as part of his incoming administration’s response to the pandemic. “Low-income…
Biden’s Election-Year Play to Further Expand Obamacare
The Biden administration wants to make it easier for Americans to get dental care. But don’t try booking an appointment just yet. A new regulation out this month allows states to include adult dental care as a benefit that health insurers must…
Medicare Stumbles Managing a Costly Problem — Chronic Illness
Nearly a decade ago, Medicare launched a program to help the two-thirds of beneficiaries with chronic conditions by paying their doctors an additional monthly fee to coordinate their care. The strategy has largely failed to live up to its potential;…
Doctors Take On Dental Duties to Reach Low-Income and Uninsured Patients
Kate Ruder DENVER — Pediatrician Patricia Braun and her team saw roughly 100 children at a community health clinic on a recent Monday. They gave flu shots and treatments for illnesses like ear infections. But Braun also did something most…
Unsheltered People Are Losing Medicaid in Redetermination Mix-Ups
KALISPELL, Mont. — On a cold February morning at the Flathead Warming Center, Tashya Evans waited for help with her Medicaid application as others at the shelter got ready for the day in this northwestern Montana city. Evans said she…
California Legislators Debate Froot Loops and Free Condoms
SACRAMENTO, Calif. — California state lawmakers this year are continuing their progressive tilt on health policy with dozens of proposals including a ban on a Froot Loops ingredient and free condoms for high schoolers. As states increasingly fracture along partisan…
Medical Providers Still Grappling With UnitedHealth Cyberattack: ‘More Devastating Than Covid’
Two months after a cyberattack on a UnitedHealth Group subsidiary halted payments to some doctors, medical providers say they’re still grappling with the fallout, even though UnitedHealth told shareholders on Tuesday that business is largely back to normal. “We are…
Too Big To Fail? Now It’s ‘Too Big To Hack’
The Host Mary Agnes Carey KFF Health News @maryagnescarey Read Mary Agnes’ stories. Lawmakers in Washington this week held the first congressional hearing on the Change Healthcare cyberattack, a breach that sent shock waves through the health care system as…
Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers
A wide-ranging lawsuit filed Friday outlines a moneymaking scheme by which large insurance sales agency call centers enrolled people into Affordable Care Act plans or switched their coverage, all without their permission. According to the lawsuit, filed in U.S. District…
Casi 1 de cada 4 adultos desafiliados de Medicaid siguen sin seguro, indica encuesta
Casi una cuarta parte de los adultos que fueron dados de baja de Medicaid el año pasado dicen que ahora no tienen seguro, según una encuesta que detalla cómo decenas de millones de estadounidenses lucharon por conservar la cobertura del…
When Rogue Brokers Switch People’s ACA Policies, Tax Surprises Can Follow
Tax season is never fun. But some tax filers this year face an added complication: Their returns are being rejected because they failed to provide information about Affordable Care Act coverage they didn’t even know they had. While the concern…
Nearly 1 in 4 Adults Dumped From Medicaid Are Now Uninsured, Survey Finds
Nearly a quarter of adults disenrolled from Medicaid in the past year say they are now uninsured, according to a survey released Friday that details how tens of millions of Americans struggled to retain coverage in the government insurance program…
Médicos de atención primaria asumen tareas de dentista para ayudar a pacientes vulnerables
DENVER.- Un lunes reciente, la pediatra Patricia Braun y su equipo atendieron a unos 100 niños en una clínica comunitaria. Administraron vacunas contra la gripe y trataron infecciones de oído. Pero Braun también hizo algo que la mayoría de los…
Attack of the Medicare Machines
Dan Weissmann Covering the American health care system means we tell some scary stories. This episode of “An Arm and a Leg” sounds like a real horror movie. It uses one of Hollywood’s favorite tropes: machines taking over. And the…
After Public Push, CMS Curbs Health Insurance Agents’ Access to Consumer SSNs
Until last week, the system that is used to enroll people in federal Affordable Care Act insurance plans inadvertently allowed access by insurance brokers to consumers’ full Social Security numbers, information brokers don’t need. That raised concerns about the potential…
Rising Complaints of Unauthorized Obamacare Plan-Switching and Sign-Ups Trigger Concern
Federal and state regulators aren’t doing enough to stop the growing problem of rogue health insurance brokers making unauthorized policy switches for Affordable Care Act policyholders, say consumers, agents, nonprofit enrollee assistance groups, and other insurance experts. “We think it’s…
Journalists Assess the Risks of Bird Flu and the Impacts of Medicaid ‘Unwinding’
KFF Health News senior fellow and editor-at-large for public health Céline Gounder discussed bird flu on CBS News’ “CBS Mornings” on April 2. Click here to watch Gounder on “CBS Mornings” El Tímpano reporter Jasmine Aguilera, who has been reporting…
Biden Is Right About $35 Insulin Cap but Exaggerates Prior Costs for Medicare Enrollees
Samantha Putterman, PolitiFact Insulin for Medicare beneficiaries “was costing 400 bucks a month on average. It now costs $35 a month.” President Joe Biden, in a March 22 speech The cost of insulin in the United States has risen considerably…
Unauthorized Sign-Ups Cast Shadow on Obamacare’s Record Enrollment
The Biden administration faces what looks like a growing problem for the federal Affordable Care Act’s insurance exchange: disreputable insurance brokers enrolling people who don’t need coverage or switching them to new plans without their authorization. It happened to Michael…
Feds Join Ranks of Employers with Generous Fertility Benefits
Companies have increasingly offered generous fertility benefits to attract and keep top-notch workers. Now, the federal government is getting in on the act. Starting this year, federal employees can choose plans that cover several fertility services, including up to $25,000…
The GOP Keeps Pushing Medicaid Work Requirements, Despite Setbacks
Work requirements in Medicaid expansion programs are back on the agenda in many statehouses — despite their lackluster track record. In Mississippi, the idea has momentum from GOP lawmakers advancing legislation to expand Medicaid. In Kansas, the Democratic governor proposed…
Adultos mayores, agotados por tener que organizar tanta atención médica
En enero, Susanne Gilliam, de 67 años, estaba yendo a recoger el correo afuera de su casa cuando se cayó al resbalar sobre una capa de hielo negro. Sintió una punzada de dolor en la rodilla y el tobillo de…
ACA Plans Are Being Switched Without Enrollees’ OK
Some consumers covered by Affordable Care Act insurance plans are being switched from one plan to another without their express permission, potentially leaving them unable to see their doctors or fill prescriptions. Some face large IRS bills for back taxes….
Adolescentes podrían ir al psicólogo sin tener el permiso de sus padres
Cuando estaba en noveno grado, Fiona Lu cayó en una depresión. Tenía problemas para adaptarse a su nueva escuela en Orange County, California, y se sentía tan aislada y agotada que lloraba todas las mañanas. Lu quería recibir ayuda, pero…
The Burden of Getting Medical Care Can Exhaust Older Patients
Susanne Gilliam, 67, was walking down her driveway to get the mail in January when she slipped and fell on a patch of black ice. Pain shot through her left knee and ankle. After summoning her husband on her phone,…
Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
Bart Klion, 95, and his wife, Barbara, faced a tough choice in January: The upstate New York couple learned that this year they could keep either their private, Medicare Advantage insurance plan — or their doctors at Saratoga Hospital. The…
The Supreme Court and the Abortion Pill
The Host In its first abortion case since the overturning of Roe v. Wade in 2022, the Supreme Court this week looked unlikely to uphold an appeals court ruling that would dramatically restrict the availability of the abortion pill mifepristone….
California Is Expanding Insurance Access for Teenagers Seeking Therapy on Their Own
When she was in ninth grade, Fiona Lu fell into a depression. She had trouble adjusting to her new high school in Orange County, California, and felt so isolated and exhausted that she cried every morning. Lu wanted to get…
Some Medicaid Providers Borrow or Go Into Debt Amid ‘Unwinding’ Payment Disruptions
Jason George began noticing in September that Medicaid payments had stalled for some of his assisted living facility residents, people who need help with daily living. Guardian Group Montana, which owns three small facilities in rural Montana, relies on the…
Programas de inteligencia artificial diagnostican retinopatía diabética en minutos
Christian Espinoza, director de operaciones de una red de clínicas de tratamiento del sur de California, comenzó recientemente a emplear un nuevo asistente poderoso: un algoritmo de inteligencia artificial (IA) que puede realizar exámenes de la vista con imágenes tomadas…
A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary?
Sara England was putting together Ghostbusters costumes for Halloween when she noticed her baby wasn’t doing well. Her 3-month-old son, Amari Vaca, had undergone open-heart surgery two months before, so she called his cardiologist, who recommended getting him checked out….
Georgia’s Medicaid Work Requirements Costing Taxpayers Millions Despite Low Enrollment
Andy Miller and Renuka Rayasam Georgia Gov. Brian Kemp’s plan for a conservative alternative to Obamacare’s Medicaid expansion has cost taxpayers at least $26 million so far, with more than 90% going toward administrative and consulting costs rather than medical…
En California, la cobertura de salud ampliada a inmigrantes choca con las revisiones de Medicaid
OAKLAND, California – El Medi-Cal llegó a Antonio Abundis cuando el conserje más lo necesitaba. Poco después que Abundis pasara de tener cobertura limitada a una cobertura completa en 2022, bajo la expansión del Medi-Cal de California para adultos mayores…
California’s Expanded Health Coverage for Immigrants Collides With Medicaid Reviews
OAKLAND, Calif. — Medi-Cal health coverage kicked in for Antonio Abundis just when the custodian needed it most. Shortly after Abundis transitioned from limited to full-scope coverage in 2022 under California’s expansion of Medi-Cal to older residents without legal immigration…
The ACA Turns 14 – KFF Health News
The Host The Affordable Care Act was signed into law 14 years ago this week, and Health and Human Services Secretary Xavier Becerra joined KFF Health News’ Julie Rovner on this week’s “What the Health?” podcast to discuss its accomplishments…
Biden Said Medicare Drug Price Negotiations Cut the Deficit by $160B. That’s Years Away.
Amy Sherman, PolitiFact We cut the federal deficit by $160 billion because Medicare will no longer have to pay those exorbitant prices to Big Pharma. President Joe Biden in his State of the Union address, March 7, 2024 President Joe…
A Battle Between Drugmakers and Insurers Hits Patients in the Wallet
There’s a long-running battle between insurers and drugmakers over financial assistance programs that purport to help patients afford expensive drugs. And lately, insurers have been losing ground as lawmakers, regulators and courts weigh in. The issue is whether coupons and…
Sitios de telesalud prometen una cura para la “menopausia masculina” a pesar de prohibiciones
Durante el boom de la telemedicina por la pandemia de covid-19, surgieron tiendas online que promocionaban la testosterona como remedio para las afecciones masculinas relacionadas con la edad, a pesar de las normas de la Administración de Drogas y Alimentos…
Under Fire for Massive Health System Hack, Biden Team Leans on Insurers
The Biden administration has hit on a strategy to deal with the massive, industry-paralyzing cyberattack on a UnitedHealth Group unit: pressuring insurers to fix it. Federal officials have been in constant conversation with senior leaders at UnitedHealth and across the…
Cuando tu cobertura de salud dentro de la red… simplemente se esfuma
Sarah Feldman, de 35 años, recibió las primeras cartas amenazantes del Centro Médico Mount Sinai en noviembre pasado. El sistema hospitalario de Nueva York le advirtió que tenía problemas para negociar un acuerdo de precios con UnitedHealthcare, que incluye los…
Covid and Medicare Payments Spark Remote Patient Monitoring Boom
Billy Abbott, a retired Army medic, wakes at 6 every morning, steps on the bathroom scale, and uses a cuff to take his blood pressure. The devices send those measurements electronically to his doctor in Gulf Shores, Alabama, and a…
How Your In-Network Health Coverage Can Vanish Before You Know It
Sarah Feldman, 35, received the first ominous letters from Mount Sinai Medical last November. The New York hospital system warned it was having trouble negotiating a pricing agreement with UnitedHealthcare, which includes Oxford Health Plans, Feldman’s insurer. “We are working…
When Copay Assistance Backfires on Patients
In early 2019, Jennifer Hepworth and her husband were stunned by a large bill they unexpectedly received for their daughter’s prescription cystic fibrosis medication. Their payment had risen to $3,500 from the usual $30 for a month’s supply. That must…
Maybe It’s a Health Care Election After All
The Host The general election campaign for president is (unofficially) on, as President Joe Biden and former President Donald Trump have each apparently secured enough delegates to become his respective party’s nominee. And health care is turning out to be…
A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?
April Dembosky, KQED A much-awaited treatment for postpartum depression, zuranolone, hit the market in December, promising an accessible and fast-acting medication for a debilitating illness. But most private health insurers have yet to publish criteria for when they will cover…
The Medicare Episode – KFF Health News
Dan Weissmann Medicare may sound like an escape from the expensive world of U.S. health insurance, but it’s more complicated, and expensive, than many realize. And decisions seniors make when they sign up for the federal health insurance program can…
Biden Team, UnitedHealth Struggle to Restore Paralyzed Billing Systems After Cyberattack
Margaret Parsons, one of three dermatologists at a 20-person practice in Sacramento, California, is in a bind. Since a Feb. 21 cyberattack on a previously obscure medical payment processing company, Change Healthcare, Parsons said, she and her colleagues haven’t been…
Biden Said State of the Union Is Strong and Made Clear His Campaign Is Off and Running
President Joe Biden touted his administration’s accomplishments in health care in a wide-ranging State of the Union address on Thursday evening that touched on subjects such as immigration, the economy, crime, job growth, infrastructure, and the Israel-Hamas war. With Biden…
The State of the Union Is … Busy
The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is…
Whistleblower Accuses Aledade, Largest US Independent Primary Care Network, of Medicare Fraud
A Maryland firm that oversees the nation’s largest independent network of primary care medical practices is facing a whistleblower lawsuit alleging it cheated Medicare out of millions of dollars using billing software “rigged” to make patients appear sicker than they…
Journalists Examine Medicaid Unwinding, Farmworkers’ Mental Health, and the Big Opioid Payback
KFF Health News senior correspondent Aneri Pattani discussed how Mobile, Alabama, is weighing whether to use opioid settlement funds to pay treatment costs now or invest in long-term solutions to cut future addiction rates on NPR’s “Morning Edition” on Feb….
Hacking at UnitedHealth Unit Cripples a Swath of the US Health System: What to Know
Darius Tahir Early in the morning of Feb. 21, Change Healthcare, a company unknown to most Americans that plays a huge role in the U.S. health system, issued a brief statement saying some of its applications were “currently unavailable.” By…
Say That Again: Using Hearing Aids Can Be Frustrating for Older Adults, but Necessary
Judith Graham It was an every-other-day routine, full of frustration. Every time my husband called his father, who was 94 when he died in 2022, he’d wait for his dad to find his hearing aids and put them in before…
Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight
Debra Prichard was a retired factory worker who was careful with her money, including what she spent on medical care, said her daughter, Alicia Wieberg. “She was the kind of person who didn’t go to the doctor for anything.” That…
If You’re Poor, Fertility Treatment Can Be Out of Reach
Mary Delgado’s first pregnancy went according to plan, but when she tried to get pregnant again seven years later, nothing happened. After 10 months, Delgado, now 34, and her partner, Joaquin Rodriguez, went to see an OB-GYN. Tests showed she…
Opposition to Medicaid Expansion Thaws in an Unexpected Place: The Deep South
For more than a decade, some Southern states have resisted Medicaid expansion under the Affordable Care Act, even though data suggest it could help their residents. Today, the large majority of uninsured Americans who would gain coverage under Medicaid expansion…
In California, Faceoff Between Major Insurer and Health System Shows Hazards of Consolidation
For weeks, more than half a million Anthem Blue Cross enrollees who receive health care from the University of California were held in suspense. It wasn’t clear whether they would have to find new doctors or switch plans as the…
Patients See First Savings From Biden’s Drug Price Push, as Pharma Lines Up Its Lawyers
Last year alone, David Mitchell paid $16,525 for 12 little bottles of Pomalyst, one of the pricey medications that treat his multiple myeloma, a blood cancer he was diagnosed with in 2010. The drugs have kept his cancer at bay….
Southern Lawmakers Rethink Long-Standing Opposition to Medicaid Expansion
Daniel Chang and Andy Miller As a part-time customer service representative, Jolene Dybas earns less than $15,000 a year, which is below the federal poverty level and too low for her to be eligible for subsidized health insurance on the…
States Get in on the Prior Authorization Crackdown
Last month, my colleague Lauren Sausser told you about the Biden administration’s crackdown on insurance plans’ prior authorization policies, with new rules for certain health plans participating in federal programs such as Medicare Advantage or the Affordable Care Act marketplace….
For the Love of Health Care and Health Policy
Nothing melts our hearts like a health policy valentine. Readers made us swoon this season, writing poetic lines about prescription drug pricing, medical debt, primary care shortages, and more. Here are some of our favorites, starting with the grand prize…
The No Surprises Act Comes With Some Surprises
The No Surprises Act, the landmark law intended to protect patients from surprise out-of-network medical bills, has come with, well, some surprises. A little more than two years after it took effect, there’s good and bad news about how it’s…
In Fight Over Medicare Payments, the Hospital Lobby Shows Its Strength
In the battle to control health care costs, hospitals are deploying their political power to protect their bottom lines. The point of contention: For decades, Medicare has paid hospitals — including hospital-owned physician practices that may not be physically located…
States Target Health Insurers’ ‘Prior Authorization’ Red Tape
Bram Sable-Smith Christopher Marks noticed an immediate improvement when his doctor prescribed him the Type 2 diabetes medication Mounjaro last year. The 40-year-old truck driver from Kansas City, Missouri, said his average blood sugar reading decreased significantly and that keeping…
¿Ofrecer vivienda gratis es atención médica? Programas de Medicaid dicen que sí
Estados están invirtiendo miles de millones de dólares en un experimento de atención médica de alto riesgo: utilizar fondos ya escasos de seguros de salud públicos para proporcionar vivienda a los estadounidenses más pobres y enfermos. California está liderando esta…
Halfway Through ‘Unwinding,’ Medicaid Enrollment Is Down About 10 Million
Halfway through what will be the biggest purge of Medicaid beneficiaries in a one-year span, enrollment in the government-run health insurance program is on track to return to roughly pre-pandemic levels. Medicaid, which covers low-income and disabled people, and the…