Category: Health Care Costs

Dancing Under the Debt Ceiling

House Republicans passed their plan to raise the nation’s debt ceiling, along with major cuts to health (and other domestic) programs. Unlikely to become law, it calls for new work requirements for adults on Medicaid. Meanwhile, state efforts targeting trans people bear a striking resemblance to the fight against abortion rights. Jessie Hellmann of CQ Roll Call, Shefali Luthra of The 19th, and Sarah Karlin-Smith of the Pink Sheet join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Renuka Rayasam, who reported the latest KFF Health News-NPR “Bill of the Month” feature, about a specialist’s demand to be paid as much as $15,000 before treating a woman’s serious pregnancy complication.

Expectant Mom Needed $15,000 Overnight to Save Her Twins

Doctors rushed a pregnant woman to a surgeon who charged thousands upfront just to see her. The case reveals a gap in medical billing protections for those with rare, specialized conditions.

Will They or Won’t They (Block the Abortion Pill)?

The Supreme Court is considering the future of the abortion pill mifepristone, after GenBioPro sued the FDA over limitations that effectively block generic production of the drug, a major part of the market. Congress is considering proposals that would impose Medicaid work requirements, crack down on pharmacy benefit managers, and more. And President Joe Biden moved to expand health coverage to young immigrants known as “Dreamers.” Rachel Cohrs of Stat, Sandhya Raman of CQ Roll Call, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KFF Health News’ Mary Agnes Carey to discuss these issues and more.

A $229,000 Medical Bill Goes to Court

In 2014, Lisa French had spinal surgery. Before the operation, she was told she would have to pay $1,337 in out-of-pocket costs and that her insurance would cover the rest. However, the hospital ended up sending French a bill for $229,000. When she didn’t pay, it sued her. The case went all the way to […]

Lose Weight, Gain Huge Debt: NY Provider Has Sued More Than 300 Patients Who Had Bariatric Surgery

The private equity-backed practice has been known to demand more than $100,000 in charges or penalties. One patient is fighting back.

California’s Medicaid Experiment Spends Money to Save Money — And Help the Homeless

Gov. Gavin Newsom’s ambitious experiment in health care is supposed to cut costs as it fills the needs of hard-to-reach people. The program’s start is chaotic and limited, but it shows promise.

The Drug Company That Prospered Without Creating Any Drugs

Horizon Therapeutics, which Amgen is acquiring for about $28 billion, grew large by snapping up cheap drugs from other companies, marketing them to perfection, and jacking up prices.

For Uninsured People With Cancer, Securing Care Can Be Like Spinning a Roulette Wheel

When uninsured people are diagnosed with cancer, accessing resources and paying for treatment can be daunting. The safety nets meant to help often fall short, say cancer physicians and health policy experts who study access to care. Some patients find it easier to play the odds.

Special Medicaid Funds Help Most States, but Prompt Oversight Concerns

Georgia is among 35-plus states that have used an under-the-radar federal funding mechanism to boost payments for hospitals and other providers under Medicaid. But a government watchdog and a congressional advisory commission say sparse oversight makes it hard to tell if the “directed payments” program is meeting its goals.

No-Cost Preventive Services Are Now in Jeopardy. Here’s What You Need to Know.

A federal judge’s recent ruling on the Affordable Care Act is by no means the final word. Even parsing its impact is complicated. Here are key issues to watch as the case works its way through the legal system.