California Aims to Maximize Health Insurance Subsidies for Workers During Labor Disputes
Workers who lose employer-based health coverage during a strike or lockout will have access to a full-subsidy plan through Covered California.
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Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges
Taxpayers had to foot the bills for care that should have cost far less, according to records released after KHN filed a lawsuit under the Freedom of Information Act. The government may seek to recover up to $650 million as a result.
By Fred Schulte and Holly K. Hacker -
Path Cleared for Georgia to Launch Work Requirements for Medicaid
Federal officials have apparently stopped fighting Georgia’s plan for a limited Medicaid expansion that includes work requirements. The plan, a key policy of Republican Gov. Brian Kemp’s, would cover a much smaller portion of the population: those who can work or volunteer 80 hours a month.
By Andy Miller and Sam Whitehead -
How Optimism Can Close the Medicaid Coverage Gap
Low-income residents in states that haven’t expanded Medicaid are in a tough spot: They don’t qualify for the subsidies that people with slightly higher incomes get to buy marketplace plans because of a glitch in the federal health law. But a court decision last year makes it easier for them to make good-faith estimates of a pay increase, and there is no financial penalty if they don’t hit that figure.
By Phil Galewitz and Daniel Chang -
Medicare Plan Finder Likely Won’t Note New $35 Cap on Out-of-Pocket Insulin Costs
In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.
By Susan Jaffe -
California Stockpiles Penalties From Uninsured Residents Instead of Lowering Care Costs
California is collecting hundreds of millions of dollars a year in tax penalties from uninsured residents. The state was supposed to use the money to help lower costs for Californians who couldn’t afford insurance but hasn’t distributed any of the revenue it has collected — citing uncertain economic times.
By Angela Hart -
‘An Arm and a Leg’: No Money, No Job, No Health Care? Not Always.
For many Americans, it’s open enrollment season for 2023 health insurance. One listener asked: If you don’t have a job and are too old to be on your parents’ plan, does it make sense to rely on charity care? This episode breaks it all down.
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Journalists Tackle the Midterms and Open Enrollment
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.
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Stopping the Churn: Why Some States Want to Guarantee Medicaid Coverage From Birth to Age 6
Oregon has become the first state to allow kids to stay in the government health care program from birth to age 6, no matter if their household income changes. California, Washington, and New Mexico are pursuing similar policies.
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South Dakota Voters Approved Medicaid Expansion, but Implementation May Not Be Easy
South Dakotans voted to expand the state’s Medicaid program to cover thousands of additional low-income residents. But as other conservative states have shown, voter approval doesn’t always mean politicians and administrators will rush to implement the change.
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Defense Department Health Plan Cuts Its Pharmacy Network by Nearly 15,000 Outlets
Many of the pharmacies were small, independent operations that had decided not to participate next year because of the lowered reimbursement being offered. But they were surprised by an early dismissal, and some patients with specialized drug needs could face difficulties in the transition.
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KHN’s ‘What the Health?’: ACA Open Enrollment Without the Drama
The Affordable Care Act’s 10th annual open-enrollment period began Nov. 1 and runs through Jan. 15, 2023, in most states. But for the first time, the health law seems to be enrolling Americans with far less controversy than in previous years. Meanwhile, as Election Day approaches, Democrats are focusing on GOP efforts to cut Social Security and Medicare. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Tami Luhby of CNN, and Julie Appleby of KHN join KHN’s Julie Rovner to discuss these topics and more. Also this week, Rovner interviews KHN’s Arthur Allen, who wrote the latest KNH-NPR Bill of the Month, about an old but still very expensive cancer drug.
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Cash for Colonoscopies: Colorado Tries to Lower Health Costs Through Incentives
State employees could receive checks ranging from $50 to thousands of dollars if they choose the right provider.
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This Open Enrollment Season, Look Out for Health Insurance That Seems Too Good to Be True
Complaints about misleading health insurance marketing are soaring. State insurance commissioners are taking notice. They’ve created a shared internal database to monitor questionable business practices, and, in the future, they hope to provide a public-facing resource for consumers. In the meantime, consumers should shop wisely as open enrollment season begins.
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Shopping for ACA Health Insurance? Here’s What’s New This Year
Consumers may find relief in some key changes made by Congress and the Biden administration, although other issues remain unsettled.
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Employers Are Concerned About Covering Workers’ Mental Health Needs, Survey Finds
Nearly half of large employers report that increasing numbers of their workers were using mental health services, according to a KFF annual employer survey. Yet almost a third of those employers said their health plan’s network didn’t have enough behavioral health care providers for employees to have timely access to the care they need.
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Montana Backs Away From Innovative Hospital Payment Model. Other States Are Watching.
Montana has been a national model for how employers could gain control and transparency over medical bills. Upcoming changes to its model have health care price experts wondering whether the state is making improvements or losing focus.
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Readers and Tweeters Take Positions on Sleep Apnea Treatment
KHN gives readers a chance to comment on a recent batch of stories.
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A Billing Expert Saved Big After Finding an Incorrect Charge in Her Husband’s ER Bill
A medical billing specialist investigated her husband’s ER bill. Her sleuthing took over a year but knocked thousands of dollars off the hospital’s charges — and provides a playbook for other consumers.
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Kids’ Mental Health Care Leaves Parents in Debt and in the Shadows
A youth mental health crisis and a shortage of therapists and other care providers who take insurance are pushing many families into financial ruin. But it's rarely acknowledged as medical debt.