State Exchange Directors Seeing Consumers’ Fears — In Real Time — About Obamacare Premium Hikes
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Sticker Shock: Obamacare Customers Confront Premium Spikes as Congress Dithers
With subsidies that give consumers extra help paying their health insurance premiums set to expire, lawmakers are again debating the Affordable Care Act. The difference this time: It’s happening in the middle of ACA open enrollment.
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Plan-Switching, Sign-Up Impersonations: Obamacare Enrollment Fraud Persists
Investigators from the Government Accountability Office were able to register nearly 20 fake ACA enrollments in a probe of healthcare.gov. The federal government paid subsidies to insurers for some of the fake customers.
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How Delays and Bankruptcy Let a Nursing Home Chain Avoid Paying Settlements for Injuries and Deaths
Genesis HealthCare’s bankruptcy case in Dallas will allow the nursing home chain to avoid paying millions of dollars it promised for residents who were injured or died while in its care. Families say bankruptcy nullifies one of the main ways to hold nursing home owners accountable for poor care.
By Jordan Rau -
Tracking Applications for Rural Health Transformation Funds
ϳԹ News is working to collect and post complete application materials, by state, here and will update this repository as new materials, released in response to public records requests, arrive.
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Republicans Left Tribes Out of Their $50B Rural Fund. Now It’s Up to States To Share.
The Trump administration has championed its Rural Health Transformation Program as an investment in American families who have been left behind. But Native American tribes, whose communities have a significant presence in rural America and have some of the greatest health needs, are ineligible to apply directly for funding.
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Feds Promised ‘Radical Transparency’ but Are Withholding Rural Health Fund Applications
Proposals from states that have shared their applications to a new $50 billion rural health program include using drones to deliver medication, installing refrigerators to expand access to healthy produce, and bringing telehealth to libraries, day cares, and senior centers.
By Sarah Jane Tribble and Arielle Zionts -
Complaints About Gaps in Medicare Advantage Networks Are Common. Federal Enforcement Is Rare.
Health systems drop out of Medicare Advantage plans all the time. Yet government documents obtained by ϳԹ News show that federal regulators rarely warn plans that their networks of health providers are so skimpy they violate legal requirements.
By Susan Jaffe -
Concerns Over Fairness, Access Rise as States Compete for Slice of $50B Rural Health Fund
Amid public forums and local cries for help, states are also talking with large health systems, technology companies, and others amid intensifying competition for shares of a $50 billion fund to improve rural health.
By Sarah Jane Tribble and Arielle Zionts -
Trump’s HHS Orders State Medicaid Programs To Help Find Undocumented Immigrants
Federal health authorities have taken the "unprecedented" step of instructing states to investigate certain individuals on Medicaid to determine whether they are ineligible because of their immigration status, with five states reporting they’ve received more than 170,000 names collectively.
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A Ticking Clock: How States Are Preparing for a Last-Minute Obamacare Deal
Even if Congress strikes a deal soon to extend more generous Affordable Care Act subsidies, the prices and types of ACA plans available could change dramatically. Unprecedented uncertainty and upheaval could cloud this year’s open enrollment season, which begins in most states on Saturday.
By Amanda Seitz and Julie Appleby -
Officials Show Little Proof That New Tech Will Help Medicaid Enrollees Meet Work Rules
The Trump administration says it’s developing a digital tool to help people prove they’re meeting new Medicaid work requirements. ϳԹ News talked to officials from the two states running pilot programs and found little evidence of new — or effective — technology.
By Rae Ellen Bichell and Sam Whitehead -
States Jostle Over $50B Rural Health Fund as Trump’s Medicaid Cuts Trigger Scramble
States are battling for their piece of $50 billion in federal rural health funding, but it’s not just hospitals vying for the money. Tech startups and policy demands are raising the stakes as Medicaid cuts loom.
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AI Will Soon Have a Say in Approving or Denying Medicare Treatments
A pilot program testing the use of artificial intelligence to expand prior authorization decisions in Medicare has providers, politicians, and researchers questioning Trump administration promises to curb an unpopular practice that has frustrated patients and their doctors.
By Lauren Sausser and Darius Tahir -
As the Trump Administration and States Push Health Data Sharing, Familiar Challenges Surface
Despite billions of tax dollars and two decades of effort invested in improving health care data sharing, Americans’ medical records often remain siloed, leading to duplicate testing, increased costs, and wasted time for patients and doctors.
By Sarah Kwon On Capitol Hill, RFK Defends Firings at CDC
Episode 412A combative Robert F. Kennedy Jr, the U.S. secretary of health and human services, appeared before a Senate committee Thursday, defending his firing of the newly confirmed director of the Centers for Disease Control and Prevention as well as other changes that could limit the availability of vaccines. Meanwhile, Congress has only a few weeks to complete work on annual spending bills to avoid a possible government shutdown and to ward off potentially large increases in premiums for Affordable Care Act health plans. Jessie Hellmann of CQ Roll Call, Sarah Karlin-Smith of Pink Sheet, and Alice Miranda Ollstein of Politico join ϳԹ News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews ϳԹ News’ Tony Leys, who discusses his “Bill of the Month” report about a woman’s unfortunate interaction with a bat — and her even more unfortunate interaction with the bill for her rabies prevention treatment.
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Trump Administration Investigates Medicaid Spending on Immigrants in Blue States
The Centers for Medicare & Medicaid Services is hunting for Medicaid waste, fraud, and abuse in at least six Democratic-led states that expanded coverage to low-income and disabled immigrants without legal status, according to records obtained by ϳԹ News and The Associated Press.
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Native Americans Want To Avoid Past Medicaid Enrollment Snafus as Work Requirements Loom
As states prepare to implement changes to Medicaid required by President Donald Trump’s recent tax-and-spending law, tribal leaders say they are concerned Native American enrollees could lose their coverage, despite exemptions made by Congress.
Kennedy Cancels Vaccine Funding
Episode 409The Health and Human Services secretary is winding down nearly $500 million in mRNA research funding, citing false claims that the technology is ineffective against respiratory illnesses — and notching a victory for critics of the covid vaccines. And President Donald Trump is demanding drugmakers drop their prices, quickly, but it’s unclear how he could make them comply. Lauren Weber of The Washington Post, Sandhya Raman of CQ Roll Call, and Sarah Karlin-Smith of the Pink Sheet join ϳԹ News’ Emmarie Huetteman to discuss these stories and more.
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Are 5 Million Nondisabled Medicaid Recipients Watching TV All Day? That’s Unsupported
CNN pundit Scott Jennings said almost 5 million nondisabled Medicaid recipients "simply choose not to work" and "spend six hours a day socializing and watching television." But a recent analysis found only about 300,000 cited a lack of interest in working as the reason they were unemployed.