Insurance
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ACA Plans Are Being Switched Without Enrollees OK
Insurance agents say its too easy to access consumer information on the Affordable Care Act federal marketplace. Policyholders can lose their doctors and access to prescriptions. Some end up owing back taxes.
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Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. Theres a way out.
By Susan Jaffe The Supreme Court and the Abortion Pill
Episode 340The Supreme Court this week heard its first abortion case since overturning Roe v. Wade in 2022, about an appeals court ruling that would dramatically restrict the availability of the abortion pill mifepristone. But while it seems likely that this case could be dismissed on a technicality, abortion opponents have more challenges in the pipeline. Meanwhile, health issues are heating up on the campaign trail, as Republicans continue to take aim at Medicare, Medicaid, and the Affordable Care Act all things Democrats are delighted to defend. Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet, and Lauren Weber of The Washington Post join 窪蹋勛圖厙 News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews 窪蹋勛圖厙 News Tony Leys, who wrote a 窪蹋勛圖厙 News-NPR Bill of the Month feature about Medicare and a very expensive air-ambulance ride. Plus, for extra credit, the panelists suggest health policy stories they read this week they think you should read, too.
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California Is Expanding Insurance Access for Teenagers Seeking Therapy on Their Own
A California law that takes effect this summer will grant minors on public insurance the ability to get mental health treatment without their parents consent, a privilege that their peers with private insurance have had for years. But the law has become a flashpoint in the states culture wars.
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Navigating Aging
The Burden of Getting Medical Care Can Exhaust Older Patients
Its estimated that an older patient can spend three weeks of the year getting care and that doesnt count the time it takes to arrange appointments or deal with insurance companies.
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Some Medicaid Providers Borrow or Go Into Debt Amid Unwinding Payment Disruptions
Used to operating with scarce resources, Montana Medicaid providers say gaps in state payments have left them struggling further.
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A Moms $97,000 Question: How Was Her Babys Air-Ambulance Ride Not Medically Necessary?
There are legal safeguards to protect patients from big bills like out-of-network air-ambulance rides. But insurers may not pay if they decide the ride wasnt medically necessary.
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Californias Expanded Health Coverage for Immigrants Collides With Medicaid Reviews
A state policy to extend Medi-Cal to qualified Californians without legal residency is running up against a federal requirement to resume eligibility checks. The redetermination process is causing many Latinos, who make up a majority of Medi-Cal beneficiaries, to be disenrolled.
The ACA Turns 14
Episode 339Saturday marks the 14th anniversary of the still somewhat embattled Affordable Care Act. Health and Human Services Secretary Xavier Becerra joins host Julie Rovner to discuss the accomplishments of the health law and the challenges it still faces. Also this week, Alice Miranda Ollstein of Politico, Tami Luhby of CNN, and Mary Agnes Carey of 窪蹋勛圖厙 News join Rovner to discuss what should be the final funding bill for HHS for fiscal 2024, next weeks Supreme Court oral arguments in a case challenging abortion medication, and more. Plus, for extra credit, the panelists suggest health policy stories they read this week they think you should read, too.
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窪蹋勛圖厙 News & PolitiFact HealthCheck
Biden Said Medicare Drug Price Negotiations Cut the Deficit by $160B. That’s Years Away.
Savings estimated by the Congressional Budget Office from allowing the federal government to negotiate Medicare drug prices are based on a 10-year cumulative projection.
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Georgias Medicaid Work Requirements Costing Taxpayers Millions Despite Low Enrollment
Republican Gov. Brian Kemps Georgia Pathways to Coverage program has seen anemic enrollment while chalking up millions in start-up costs largely in technology and consulting fees. Critics say the moneys being wasted on a costly and ineffective alternative to Obamacares Medicaid expansion.
By Andy Miller and Renuka Rayasam -
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Covid and Medicare Payments Spark Remote Patient Monitoring Boom
Demand for help monitoring patients vital signs remotely has taken off since a Medicare change in 2019. Dozens of companies now push the service to help overburdened primary care doctors and as a revenue stream. But some policy experts say its growth has outpaced oversight and evidence of effectiveness.
By Phil Galewitz and Holly K. Hacker -
Perspective
How Your In-Network Health Coverage Can Vanish Before You Know It
One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of qualifying life events. But insurers contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.
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When Copay Assistance Backfires on Patients
Drugmakers offer copay assistance programs to patients, but insurers are tapping into those funds, not counting the amounts toward patient deductibles. That leads to unexpected charges. But the practice is under growing scrutiny.
Maybe Its a Health Care Election After All
Episode 338Health care wasnt expected to be a major theme for this years elections. But as President Joe Biden and former President Donald Trump secured their respective party nominations this week, the future of both Medicare and the Affordable Care Act appears to be up for debate. Meanwhile, the cyberattack of the UnitedHealth Group subsidiary Change Healthcare continues to do damage to the companies finances with no quick end in sight. Margot Sanger-Katz of The New York Times, Anna Edney of Bloomberg News, and Joanne Kenen of Johns Hopkins University and Politico Magazine join 窪蹋勛圖厙 News Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Kelly Henning of Bloomberg Philanthropies about a new, four-part documentary series on the history of public health, The Invisible Shield. Plus, for extra credit the panelists suggest health policy stories they read this week that they think you should read, too.
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A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?
A pill form of an effective drug for postpartum depression hit the market in December, but most insurers do not yet have a policy on when or whether they will pay for it. The hurdles to obtain its predecessor medication have advocates worried.
The Medicare Episode
Season 11, Episode 3On this episode of An Arm and a Leg, host Dan Weissmann breaks down the complicated and expensive world of Medicare with practical tips to pick the right plan and avoid penalties.