Category: Health Care Costs

The Case of the $489,000 Air Ambulance Ride

Diagnosed with aggressive leukemia on a Western trip, a young man thought his insurance would cover an air ambulance ride home to North Carolina. Instead, questions about medical necessity left him with an astronomical bill.

KHN’s ‘What the Health?’: The ACA Turns 12

Although its fate was in doubt more than a few times, the Affordable Care Act turned 12 this week. Year 13 could be pivotal in determining how many Americans receive ACA health insurance, and at what price. Meanwhile, three leading credit bureaus agreed to stop using most medical debt to measure U.S. consumers’ creditworthiness. Anna Edney of Bloomberg News, Rachel Cohrs of Stat, and KHN’s Mary Agnes Carey join KHN’s Julie Rovner to discuss these issues and more.

How to Avoid Surprise Bills — And the Pitfalls in the New Law

The No Surprises Act offers protection from many surprise medical bills — but that protection may be only as good as a patient’s knowledge of the law and ability to make sure it’s enforced. Here’s what you need to know.

Want Vulnerable Californians to Have Healthier Pregnancies? Doulas Say the State Must Pay Up.

California was supposed to start paying doulas this year to help Medicaid enrollees have healthy pregnancies. But the benefit has been delayed because doulas feel lowballed by the state’s proposed reimbursement rate, which is below what most other states pay.

Want Vulnerable Californians to Have Healthier Pregnancies? Doulas Say the State Must Pay Up.

California was supposed to start paying doulas this year to help Medicaid enrollees have healthy pregnancies. But the benefit has been delayed because doulas feel lowballed by the state’s proposed reimbursement rate, which is below what most other states pay.

‘An Arm and a Leg’: Need an Expensive Drug? Here’s What You Need to Know

Even a personal finance expert can get stuck with a huge unexpected bill for a drug. Listen up for what you need to know about “copay accumulators.”

KHN’s ‘What the Health?’: Congress Shelves Covid Funding for Now

The Biden administration’s request for billions more in funding to fight covid-19 hit a snag on Capitol Hill this week, as Democrats objected to Republican demands that money allocated to states but not yet spent be reclaimed. Meanwhile, the big annual spending bill about to cross the finish line addresses other health policy changes, such as giving the FDA authority to regulate “synthetic” nicotine. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Rachel Cohrs of Stat, and Jessie Hellmann of Modern Healthcare join KHN’s Julie Rovner to discuss these issues and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too.

$35 Insulin Cap Is Welcome, Popular, and Bipartisan. But Congress May Not Pass It Anyway.

Spun off from the ailing but not-quite-dead Build Back Better legislation, a popular proposal to cap out-of-pocket insulin costs at $35 a month faces tough political realities that could kill it.

KHN’s ‘What the Health?’: A Health-Heavy State of the Union

President Joe Biden spent a large portion of his first State of the Union address talking about foreign affairs, but he also spent time on an array of health topics, including mental health, nursing home regulation, and toxic burn pits. Also this week, the administration unveiled a strategy to address the covid pandemic going forward. Alice Miranda Ollstein of Politico, Amy Goldstein of The Washington Post, and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these issues and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too.

HIV Preventive Care Is Supposed to Be Free in the US. So, Why Are Some Patients Still Paying?

The Department of Labor issued rules in July clarifying that health plans need to cover the costs of prescription drugs proven to prevent HIV infection, along with related lab tests and medical appointments, at no cost to patients. More than half a year later, the erroneous billing continues.