Category: Insurance

Why Does Insulin Cost So Much? Big Pharma Isn’t the Only Player Driving Prices

Big Pharma may be moving on from squeezing diabetes patients on insulin prices, but it’s the arbitrators that jack up prices for those who can least afford them.

Medicaid Health Plans Try to Protect Members — And Profits — During Unwinding

States are turning to the big health insurance companies to keep Medicaid enrollees insured once pandemic protections end in April. The insurers’ motive: profits.

March Medicaid Madness

With Medicare and Social Security apparently off the table for federal budget cuts, the focus has turned to Medicaid, the federal-state health program for those with low incomes. President Joe Biden has made it clear he wants to protect the program, along with the Affordable Care Act, but Republicans will likely propose cuts to both […]

California’s Massive Medicaid Program Works for Some, but Fails Many Others

Medi-Cal serves more than one-third of the state’s population — offering a dizzying range of care to a diverse population. In the new “Faces of Medi-Cal” series, California Healthline will assess the program’s strengths and weaknesses through the lives and experiences of its enrollees.

After People on Medicaid Die, Some States Aggressively Seek Repayment From Their Estates

States take drastically different approaches to recovering Medicaid money from deceased participants’ estates. Demands for repayment of Medicaid spending can drain the assets a person leaves behind, depending on where they lived.

Biden Promises to Fight GOP on ‘Gutting’ Medicaid. Budget Talks Seem Like Another Story.

As many lower-income Americans prepare to lose pandemic-era access to Medicaid, President Joe Biden vowed to stop Republicans from making deeper cuts to lower the national debt. Other changes may still be up for discussion.

Idaho Dropped Thousands From Medicaid in the Pandemic’s First Years

The removals, detailed in emails between state and federal health officials, hinged on disagreements over how states could disenroll people during the public health emergency. Consumer advocates fear the alleged violation signals the mess to come on April 1, when the pandemic-era Medicaid coverage mandate ends.

Surprise-Billing Law Loophole: When ‘Out of Network’ Doesn’t Quite Mean Out of Network

Billing experts and lawmakers are playing catch-up as providers find ways to get around new surprise-billing laws, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.

Readers and Tweeters Urgently Plea for a Proper ‘Role’ Call in the ER

KHN gives readers a chance to comment on a recent batch of stories.

California Explores Private Insurance for Immigrants Lacking Legal Status. But Is It Affordable?

Nearly half a million Californians without legal residency make too much to qualify for Medicaid yet they can’t afford to buy coverage. A state lawmaker is proposing to open up the state’s health insurance exchange as a first step to providing them affordable insurance.