Work Requirements Might Cut Medicaid Spending. But at What Cost?Â
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Covered California Pushes for Better Health Care as Federal Spending Cuts Loom
Monica Soni, Covered California’s chief medical officer, oversees an effort to hold health plans financially accountable for the quality of care they provide, including childhood vaccination rates, which have fallen in California and nationwide. She worries federal spending cuts could soon bring turbulence to the state’s Affordable Care Act marketplace.
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Government Watchdog Expects Medicaid Work Requirement Analysis by Fall
This fall, the U.S. Government Accountability Office expects to release a report on how much it costs to run Georgia Pathways to Coverage — the country’s only active Medicaid work requirement program — as other states and Congress consider similar programs.
By Sam Whitehead and Renuka Rayasam -
The Patient Expected a Free Checkup. The Bill Was $1,430.
Carmen Aiken of Chicago thought their medical appointment would be covered because the Affordable Care Act requires insurers to pay for a long list of preventive services. But after the appointment, Aiken received a bill for more than $1,400.
By Samantha Liss and Lauren Sausser -
When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get To Leave, Too
Breakups between health providers and Advantage plans are increasingly common. The Centers for Medicare & Medicaid Services has allowed whole groups of patients to leave their plans.
By Susan Jaffe -
Montana Hospitals Preserve Medicaid Expansion, Fend Off Regulations
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What ‘Fertilization President’ Trump Can Learn From State Efforts To Expand IVF Access
State-level efforts to regulate fertility coverage reveal the gauntlet of budgetary and political hurdles such initiatives face — obstacles that have led to millions of people being left out even when mandates become law.
By Sarah Kwon -
Medi-Cal Under Threat: Who’s Covered and What Could Be Cut?
Federal law requires states to offer health insurance to many people with low incomes or disabilities. But some states, including California, are far more generous than what’s required. Budget pressures may force lawmakers to cut benefits that have led to a historic low in the uninsured rate.
By Don Thompson -
Hospitals’ Lobbying Frustrates Montana Lawmakers Who Sought To Boost Oversight
Montana’s powerful hospital lobby was instrumental in renewing the state’s Medicaid expansion program and has also fended off most legislation to increase state oversight of their business.
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The Ranks of Obamacare ‘Fixers’ Axed in Trump’s Reduction of Health Agency Workforce
These fixers, officially known as caseworkers, unraveled complex and arcane health insurance rules to solve people’s coverage issues. They worked in a little-known federal department with which most consumers never interact — until they need help.
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Watch: Why Insurance Companies Are Denying Coverage for Prosthetic Limbs
Although knee replacements are usually covered by health insurance, amputees face roadblocks to coverage and often must prove their prosthetics are medically necessary.
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States Push Medicaid Work Rules, but Few Programs Help Enrollees Find Jobs
Republicans are pushing to implement requirements that Medicaid recipients work in order to obtain or retain coverage. Some states try to help enrollees find jobs. But states lack the data to show whether they’re effective.
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Some Rural Hospitals Ditch Medicare Advantage
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Tax Time Triggers Fraud Alarms for Some Obamacare Enrollees
Consumers who were enrolled fraudulently in Affordable Care Act coverage could receive unexpected tax bills — the first and possibly only clue they were a victim of fraud. Getting help may become difficult as federal workers are laid off and funding for assistance programs is cut.
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Rural Hospitals Question Whether They Can Afford Medicare Advantage Contracts
Some rural hospitals have canceled — or are considering ending — contracts with insurance companies that offer Medicare Advantage plans, saying the private policies jeopardize their finances and impede patient care.
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Blockbuster Deal Will Wipe Out $30 Billion in Medical Debt. Even Backers Say It’s Not Enough.
Undue Medical Debt is retiring unpaid medical bills for 20 million people. The debt trading company that owned them is leaving the market.
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The House Speaker’s Eyeing Big Cuts to Medicaid. In His Louisiana District, It’s a Lifeline.
The GOP-controlled Congress is weighing cuts to Medicaid, the government health program that covers millions of Americans — including nearly 40% of Louisianans represented in the House by Speaker Mike Johnson.
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‘If They Cut Too Much, People Will Die’: Health Coalition Pushes GOP on Medicaid Funding
As House Republicans mull a massive $880 billion cut from federal programs likely including Medicaid, constituents, disability advocates, and health care providers are joining forces to lobby GOP members in California — including those who represent rural, deeply conservative pockets that stand to lose the most.
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How Much Will That Surgery Cost? 🤷 Hospital Prices Remain Largely Unhelpful.
Health care price transparency is one of the few bipartisan issues in Washington, D.C. But much of the information that hospitals and health plans have made available to the public is not helpful to patients, and there’s no conclusive evidence yet that it’s lowering costs or increasing competition.
By Daniel Chang -
‘They Won’t Help Me’: Sickest Patients Face Insurance Denials Despite Policy Fixes
The fatal shooting of UnitedHealthcare CEO Brian Thompson prompted both grief and public outrage about the ways insurers deny treatment. Republicans and Democrats agree prior authorization needs fixing, but patients are growing impatient.