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.
Category: Health Care Costs
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.
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.
Hospital Giant HCA Fends Off Accusations of Questionable Inpatient Admissions
The nation’s largest private health system, HCA Healthcare, has faced years of scrutiny over its share of emergency room patients who are admitted to the hospital. And now U.S. Rep. Bill Pascrell, a Democrat from New Jersey, is calling for a federal investigation, prompting an escalating defense by the hospital system, based in Nashville, Tennessee.
Centene Showers Politicians With Millions as It Courts Contracts and Settles Overbilling Allegations
Centene, the largest Medicaid managed-care company in the U.S., has thrown more than $26.9 million at political campaigns across the country since 2015, especially focused on states where it is wooing Medicaid contracts and settling accusations that it overbilled taxpayers. Among its tactics: Centene is skirting contribution limits by giving to candidates through its many subsidiaries.
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.