Patients are caught in the middle as insurers clamp down on paying for treatments or force prior authorizations for care.
Category: Insurance
The Pandemic Forced My Transgender Wife to Fight Our Insurer Over Hormones
The covid pandemic has caused millions of people, particularly LGBTQ adults, to lose their jobs and enroll in Medicaid or insurance through the Affordable Care Act. Yet these plans often don’t fully cover the basics needed by many transgender Americans, such as injectable estrogen, a hormone therapy commonly used by trans women.
As Democrats Bicker Over Massive Spending Plan, Here’s What’s at Stake for Medicaid
More than 2 million low-income adults are uninsured because their states have not accepted Medicaid expansion under the Affordable Care Act. Congressional Democrats want to offer them coverage in the massive spending bill being debated, but competition to get into that package is fierce.
Death in Dallas: One Family’s Experience in the Medicaid Gap
Efforts to give 2.2 million Americans health insurance hang in the balance as Congress debates a massive spending bill. The so-called Medicaid gap is felt most acutely in Texas, where about half of those who stand to gain coverage live.
A Covid Test Costing More Than a Tesla? It Happened in Texas.
A patient from Dallas got a PCR test in a free-standing suburban emergency room. The out-of-network charge: $54,000.
‘An Arm and a Leg’: They Turned Grief Into Action
This episode highlights how New York enacted a charity care law, one of the precursors to the federal provision on charity care in the Affordable Care Act.
The Solution to Au Pairs’ Health Coverage Gaps May Be Simple: ACA Plans
Private agencies that bring young adults to the U.S. to care for children generally offer basic health insurance, but plans may exclude many types of necessary care. What the agencies might not mention is that au pairs are eligible to enroll in comprehensive coverage on the Affordable Care Act marketplaces and likely qualify for premium subsidies that would make the insurance affordable.
Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans
The plans are designed for people who don’t get dental coverage through their jobs and can’t afford an individual plan. For about $300 to $400 a year, patients receive certain preventive services at no charge and other procedures at a discount.
Leader of California’s Muscular Obamacare Exchange to Step Down
Peter Lee helped create Covered California, which has been lauded as a national example among the Affordable Care Act’s insurance marketplaces, and he fiercely opposed Republican efforts to repeal the federal health reform law.
KHN’s ‘What the Health?’: Much Ado About Drug Prices
Democrats have hit a snag in their effort to compile a $3.5 trillion social-spending bill this fall — moderates are resisting support for Medicare drug price negotiation provisions that would pay for many of the measure’s health benefit improvements. Meanwhile, the new abortion restrictions in Texas have moved the divisive issue back to the political front burner. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat and Shefali Luthra of The 19th join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interview’s KHN’s Phil Galewitz about the latest KHN-NPR “Bill of the Month” installment, about two similar jaw surgeries with very different price tags.
