Category: Insurance

KHN’s ‘What the Health?’: On Government Spending, Congress Decides Not to Decide

Congress has once again decided not to decide how to fund the federal government in time for the start of the fiscal year, racing toward a midnight Sept. 30 deadline to pass a stopgap bill that would keep the lights on for two more months. However, it does appear the FDA’s program that gets drugmakers to help fund some of the agency’s review staff will be renewed in time to stop pink slips from being sent. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Victoria Knight of Axios join KHN’s Julie Rovner to discuss these topics and more. Also this week, Rovner interviews filmmaker Cynthia Lowen, whose new documentary, “Battleground,” explores how anti-abortion forces played the long game to overturn Roe v. Wade.

Turned Away From Urgent Care — And Toward a Big ER Bill

Russell Cook was expecting a quick and inexpensive visit to an urgent care center for his daughter, Frankie, after she had a car wreck. Instead, they were advised to go to an emergency room and got a much larger bill.

‘American Diagnosis’: When Indigenous People Move to Cities, Health Care Funding Doesn’t Follow

When Indigenous people started moving to cities in large numbers after World War II, many found hardship and discrimination there … but not the health care they were entitled to. Episode 12, the season finale, explores the efforts of urban Indian health providers to close those gaps by providing affordable, culturally competent care.

Health Plan Shake-Up Could Disrupt Coverage for Low-Income Californians

Four managed-care insurance plans may lose contracts with California’s Medicaid program, which would force nearly 2 million low-income residents to switch their health plans — and possibly their doctors. The plans are fighting back.

Shattered Dreams and Bills in the Millions: Losing a Baby in America

On top of fearing for their children’s lives, new parents of very fragile, very sick infants can face exorbitant hospital bills — even if they have insurance. Medical bills don’t go away if a child dies.

KHN’s ‘What the Health?’: Biden Declares the Pandemic ‘Over’

President Joe Biden, in an interview with CBS’ “60 Minutes,” declared the covid-19 pandemic “over,” stoking confusion for members of his administration trying to persuade Congress to provide more funding to fight the virus and the public to get the latest boosters. Meanwhile, concerns about a return of medical inflation is helping boost insurance premiums even as private companies race to get their piece of the health pie. Anna Edney of Bloomberg News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Lauren Weber of KHN join KHN’s Julie Rovner to discuss these issues and more. Also, for extra credit, the panelists suggest their favorite health policy stories they think you should read, too.

Centene to Pay $166 Million to Texas in Medicaid Drug Pricing Settlement

Texas is at least the 12th state to settle with St. Louis-based Centene Corp. over allegations that it overcharged Medicaid prescription drug programs.

Court Ruling May Spur Competitive Health Plans to Bring Back Copays for Preventive Services

The Affordable Care Act required that health insurers provide many medical screenings and prevention services at no out-of-pocket cost to health plan members. But insurers and employers may consider adding cost sharing for preventive services now that a federal court ruled the ACA’s mandate is unconstitutional.

Medical Coding Creates Barriers to Care for Transgender Patients

The codes used by U.S. medical providers to bill insurers haven’t caught up to the needs of trans patients or even international standards. Consequently, doctors are forced to get creative with what codes they use, or patients spend hours fighting big out-of-pocket bills.

Many Preventive Medical Services Cost Patients Nothing. Will a Texas Court Decision Change That?

A federal judge in Texas issued a decision this week that affects the Affordable Care Act. It says one way that preventive services are selected for no-cost coverage is unconstitutional.