Julie Appleby, KFF Health News A federal judge in North Dakota has ruled in favor of 19 states that challenged a Biden administration rule allowing — for the first time — enrollment in Affordable Care Act coverage by people brought to the U.S. as children without immigration paperwork, known as “Dreamers.” The move effectively bars […]

Julie Appleby, KFF Health News Un juez federal en Dakota del Norte falló a favor de 19 estados que impugnaron una regla de la administración Biden que permite —por primera vez— que las personas traídas a Estados Unidos de niños, sin papeles, conocidas como Dreamers, se inscribieran para obtener cobertura de salud a través de […]

KFF Health News senior correspondent Arthur Allen discussed the fragility of our vaccine infrastructure on The Atlantic’s “Radio Atlantic” on Dec. 5. Click here to hear Allen on “Radio Atlantic” Read Allen’s “Scientists Fear What’s Next for Public Health if RFK Jr. Is Allowed To ‘Go Wild’” KFF Health News contributor Andy Miller discussed U.S. […]

ATLANTA — Deegant Adhvaryu completed his parents’ applications for Medicaid and food benefits in June. Then the waiting and frustration began. In July, his parents, Haresh and Nina Adhvaryu, received a letter saying their applications would be delayed, he said. In August, the Adhvaryus started calling a Georgia helpline, he said, but couldn’t leave a […]

In 2017, the Republicans who controlled Congress tried mightily to slash federal spending on Medicaid, the government-funded health program covering low-income families and individuals. California, like other states, depends heavily on federal dollars to provide care for its poorest residents. Analyses at the time showed the GOP’s proposals would cut Medicaid funds flowing from Washington […]

Phil Galewitz, KFF Health News With Donald Trump’s return to the White House and Republicans taking full control of Congress in 2025, the Affordable Care Act’s Medicaid expansion is back on the chopping block. More than 3 million adults in nine states would be at immediate risk of losing their health coverage should the GOP […]

Ryan Wettstein Nauman was inconsolable one evening last December. After being put down for bed, the 3-year-old from Peoria, Illinois, just kept crying and crying and crying, and nothing would calm her down. Her mother, Maggi Wettstein, remembered fearing it could be a yeast or urinary tract infection, something they had been dealing with during […]

Daniel Chang and Samantha Liss In mid-May, Mandi Rokx had a 3-month-old baby and a letter from a Florida agency warning that they both would be cut from Medicaid, the health insurance program for people with low incomes or disabilities. Under a Florida law passed in 2021, Rokx was supposed to receive 12 months of […]

The current Affordable Care Act open enrollment season is the first big test of new federal guardrails against fraud. The rules aim to head off unauthorized ACA plan enrollments or switches by rogue agents and entities looking to make money via enrollment commissions. Such sign-ups triggered more than 274,000 consumer complaints through August this year. […]

Los cambios no autorizados en los planes médicos de la Ley de Cuidado de Salud a Bajo Precio (ACA) parecen haberse reducido en las últimas semanas: reguladores federales informaron que hay menos quejas de los consumidores. Los Centros de Servicios de Medicare y Medicaid (CMS), que supervisan ACA, atribuyen esta reducción a las medidas adoptadas […]

Unauthorized switching of Affordable Care Act plans appears to have tapered off in recent weeks based on an almost one-third drop in casework associated with consumer complaints, say federal regulators. The Centers for Medicare & Medicaid Services, which oversees the ACA, credits steps taken to thwart enrollment and switching problems that triggered more than 274,000 […]

Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that […]

President-elect Donald Trump’s choice to run the sprawling government agency that administers Medicare, Medicaid, and the Affordable Care Act marketplace — celebrity doctor Mehmet Oz — recently held broad investments in health care, tech, and food companies that would pose significant conflicts of interest. Oz’s holdings, some shared with family, included a stake in UnitedHealth […]

President-elect Donald Trump’s return to the White House could embolden Republicans who want to weaken or repeal the Affordable Care Act, but implementing such sweeping changes would still require overcoming procedural and political hurdles. Trump, long an ACA opponent, expressed interest during the campaign in retooling the health law. In addition, some high-ranking Republican lawmakers […]

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In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. […]

The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to […]

Fred Schulte, KFF Health News KFF Health News has sued the U.S. Department of Health and Human Services Office of Inspector General to compel it to release a range of Medicare Advantage health plan audits and other financial records. The suit, filed Nov. 12 in U.S. District Court in San Francisco under the Freedom of […]

Este año, California ha dado el último paso para abrir el Medi-Cal, su programa de Medicaid, a todos los residentes que reúnan los requisitos, independientemente de su estatus migratorio. Es una expansión significativa para un programa de protección social que ya de por sí es masivo. El gasto anual de Medi-Cal asciende actualmente a  $157.000 […]

California this year took the final step in opening Medi-Cal, its Medicaid program, to every eligible resident regardless of immigration status. It’s a significant expansion for an already massive safety net program. Medi-Cal’s annual spending now stands at $157 billion, serving about 15 million low-income residents, more than a third of Californians. Of those, about […]

A new federal watchdog audit is ratcheting up pressure on government officials to crack down on billions of dollars in overcharges linked to Medicare Advantage home visits. But so far, the Centers for Medicare & Medicaid Services has rejected a recommendation from the Health and Human Services Inspector General to limit payments stemming from house […]

RICHMOND, Vt. — On a warm autumn morning, Roger Brown walked through a grove of towering trees whose sap fuels his maple syrup business. He was checking for damage after recent flooding. But these days, his workers’ health worries him more than his trees’. The cost of Slopeside Syrup’s employee health insurance premiums spiked 24% […]

On the campaign trail, both former President Donald Trump and Vice President Kamala Harris are eager to portray themselves as guardians of Medicare. Each presidential candidate accuses the other of backing spending cuts and other policies that would damage the health insurance program for older Americans. But the election’s outcome could alter the very nature […]

Joanne Kenen María Sánchez emigró al área de Chicago desde México hace unos 30 años. Ahora, a sus 87, sigue viviendo en Estados Unidos sin papeles. Como muchos inmigrantes de larga data, ha trabajado —y pagado impuestos, incluyendo para Medicare— durante todo ese tiempo. Pero Sánchez nunca tuvo seguro médico, y cuando cumplió 65, no […]

In the final days of the campaign, stark disagreements between Vice President Kamala Harris and former President Donald Trump over the future of American health care are on display — in particular, in sober warnings about abortion access, the specter of future cuts to the Affordable Care Act, and bold pronouncements about empowering activists eager […]

Joanne Kenen Maria Sanchez immigrated to the Chicago area from Mexico about 30 years ago. Now 87, she’s still living in the U.S. without authorization. Like many longtime immigrants, she has worked — and paid taxes, including Medicare taxes — all that time. But Sanchez never had health insurance, and when she turned 65, she […]

It’s that time of year again: open enrollment for Affordable Care Act insurance — a period that runs from tomorrow to Jan. 15 in most states, a bit longer in some, and shorter in Idaho. One of the biggest changes this time around: a new rule from the Biden administration that opens enrollment to Deferred […]

Conservative groups are working to undermine support for Montana’s Medicaid expansion in hopes the state will abandon the program. The rollback would be the first in the decade since the Affordable Care Act began allowing states to cover more people with low incomes. Montana’s expansion, which insures roughly 78,800 people, is set to expire next […]

Kim Krisberg, Public Health Watch and Stephanie Colombini, WUSF CITRUS COUNTY, Fla. — It was hard enough for Stephanie to get methadone treatment when she moved to Florida from Indiana last year. The nearest clinic was almost an hour’s drive away and she couldn’t drive herself. But at least she didn’t have to worry about […]

This spring, a few days after his 2nd birthday, Brigland Pfeffer was playing with his siblings in their San Diego backyard. His mother, Lindsay Pfeffer, was a few feet away when Brigland made a noise and came running from the stone firepit, holding his right hand. She noticed a pinprick of blood between his thumb […]

Julie Appleby, KFF Health News When open enrollment for the Affordable Care Act, or Obamacare, starts nationwide this week, a group that had previously been barred from signing up will be eligible for the first time: The “Dreamers.” That’s the name given to children brought to the United States without immigration paperwork who have since […]

Cuando comience el período de inscripción abierta para adquirir cobertura médica en los mercados de seguros establecidos por la Ley de Cuidado de Salud a Bajo Precio, conocida como Obamacare, un grupo que antes no podía inscribirse será elegible por primera vez: los “Dreamers”. Ese es el nombre de los niños traídos a los Estados […]

Fred Clasen-Kelly and Renuka Rayasam KINGSTREE, S.C. — One morning in late April, a small brick health clinic along the Thurgood Marshall Highway bustled with patients. There was Joshua McCray, 69, a public bus driver who, four years after catching covid-19, still is too weak to drive. Louvenia McKinney, 77, arrived complaining about shortness of […]

Health care is suddenly front and center in the final sprint to the presidential election, and the outcome will shape the Affordable Care Act and the coverage it gives to more than 40 million people. Besides reproductive rights, health care for most of the campaign has been an in-the-shadows issue. However, recent comments from former […]

Tom Zawierucha, 58, a building services worker in New Jersey, wishes candidates would talk more about protecting older Americans from big medical bills. Teresa Morton, 43, a freight dispatcher in Memphis, Tennessee, with two teenagers, wants to hear more about how elected officials would help working Americans saddled with unaffordable deductibles. Yessica Gray, 28, a […]

CUTHBERT, Ga. — While customers at Adams Family Pharmacy picked up their prescriptions on a hot summer day, some stopped in for coffee, ice cream, homemade cake, or cookies. It wasn’t a bake sale, but the sweets bring extra revenue as pharmacist and co-owner Nikki Bryant works to achieve profitability at her business on the […]

Cuando Pam McClure se enteró que el próximo año ahorraría casi $4,000 en sus medicamentos recetados dijo: “parece demasiado bueno para ser verdad”. Para finales de 2024, habrá gastado casi $6,000 en estos fármacos, incluido uno para controlar su diabetes. McClure, de 70 años, es una de las aproximadamente 3.2 millones de personas con un […]

When Pam McClure learned she’d save nearly $4,000 on her prescription drugs next year, she said, “it sounded too good to be true.” She and her husband are both retired and live on a “very strict” budget in central North Dakota. By the end of this year, she will have spent almost $6,000 for her […]

Don Thompson SACRAMENTO, Calif. — This year, Gov. Gavin Newsom affirmed abortion access, calling California “a proud reproductive freedom state” and criticizing Republicans across the country for trying to take away families’ rights. He signed legislation mandating that insurance companies cover in vitro fertilization. He supported restricting students’ cellphone use in schools and signed a […]

The Host The 2024 campaign — particularly the one for president — has been notably vague on policy. But health issues, especially those surrounding abortion and other reproductive health care, have nonetheless played a key role. And while the Affordable Care Act has not been the focus of debate the way it was over the […]

Noam N. Levey Patient and consumer advocates are looking to Kamala Harris to accelerate federal efforts to help people struggling with medical debt if she prevails in next month’s presidential election. And they see the vice president and Democratic nominee as the best hope for preserving Americans’ access to health insurance. Comprehensive coverage that limits […]

Defensores de pacientes y consumidores confían en que Kamala Harris acelere los esfuerzos federales para ayudar a las personas que luchan con deudas médicas, si gana en las elecciones presidenciales del próximo mes. Y ven a la vicepresidenta y candidata demócrata como la mejor esperanza para preservar el acceso de los estadounidenses a seguros de […]

The Host As part of a media blitz aimed at women voters, Vice President Kamala Harris this week rolled out a plan for Medicare to provide in-home long-term care services. It’s popular, particularly for families struggling to care for both young children and older relatives, but its enormous expense has prevented similar plans from being […]

Montana lawmakers are looking to fast-track Medicaid coverage for older adults who need help with daily life. LISTEN here: Montana is looking to fast-track Medicaid access for older adults who need help to stay in their homes or towns. Medicaid, the joint federal-state health care program for low-income Americans, opens the door to services such […]

Most employers have little idea what the pharmacy benefit managers they hire do with the money they exchange for the medications used by their employees, according to a KFF survey released Wednesday morning. In KFF’s latest employer health benefits survey, company officials were asked how much of the rebates collected from drugmakers by pharmacy benefit […]

It’s that time of year again: In most states, the Affordable Care Act’s annual open enrollment season for health plans begins Nov. 1 and lasts through Jan. 15. Current enrollees who do not update their information or select an alternative will be automatically reenrolled in their current plan or, if that plan is no longer […]

Estamos en esa época del año otra vez. En la mayoría de los estados, la temporada de inscripción abierta de la Ley de Cuidado de Salud a Bajo Precio (ACA) para los planes de salud comienza el 1 de noviembre y dura hasta el 15 de enero. Los consumidores que no actualicen su información o […]

The Host When it comes to health care, this year’s presidential campaign is increasingly a matter of which candidate voters choose to believe. Democrats, led by Vice President Kamala Harris, say Republicans want to further restrict reproductive rights and repeal the Affordable Care Act, pointing to their previous actions and claims. Meanwhile, Republicans, led by […]

It was expected that the past year and a half would be a fraught time for Medicaid, the workhorse of the nation’s health system, which covers more people than any other government health insurance program. In April 2023, states resumed screening people for Medicaid eligibility and terminating coverage for those they said no longer qualified […]

Jacob Gardenswartz “Donald Trump said he was going to allow Medicare to negotiate drug prices. He never did. We did.” Vice President Kamala Harris at the ABC News presidential debate, Sept. 10 Since Vice President Kamala Harris entered the presidential race, she and former President Donald Trump have sparred over their approaches to lowering prescription […]

KFF Health News and PolitiFact staffs Ohio Republican Sen. JD Vance and Minnesota Democratic Gov. Tim Walz met in an Oct. 1 vice presidential debate hosted by CBS News that was cordial and heavy on policy discussion — a striking change from the Sept. 10 debate between Vice President Kamala Harris and former President Donald Trump.  Vance […]

Dave Lantz is no stranger to emergency department or doctor bills. With three kids in their teens and early 20s, “when someone gets sick or breaks an arm, all of a sudden you have thousand-dollar medical bills,” Lantz said. The family’s health plan that he used to get as the assistant director of physical plant […]

Federal officials resolved more than a decade ago to crack down on whopping government overpayments to private Medicare Advantage health insurance plans, which were siphoning off billions of tax dollars every year. But Centers for Medicare & Medicaid Services officials have yet to demand any refunds — and over the years the private insurance plans […]

KFF Health News Midwest correspondent Cara Anthony discussed healing from racial trauma on “America’s Heroes Group” on Sept. 20. Click here to watch Anthony on “America’s Heroes Group” Explore Anthony’s series on the topic, “Silence in Sikeston” KFF Health News contributor Andy Miller discussed Medicaid expansion in Georgia on WUGA’s “The Georgia Health Report” on Sept. […]

When Preston Nafz was 12, he asked his dad for permission to play lacrosse. “First practice, he came back, he said, ‘Dad, I love it,’” recalled his father, Lothar Nafz, of Hoover, Alabama. “He lives for lacrosse.” But years of youth sports took a toll on Preston’s body. By the time the teenager limped off […]

Julie Appleby, KFF Health News Donald Trump could have destroyed the Affordable Care Act, but “he chose to build upon [it].” Sen. JD Vance (R-Ohio) on “Meet the Press,” Sept. 15 Sen. JD Vance (R-Ohio) on Sept. 15 told viewers of NBC’s “Meet the Press” that former President Donald Trump built up the Affordable Care […]

Noam N. Levey TUSCALOOSA, Ala. — Like most medical offices, the small suite of exam rooms at the PhiferCares Clinic fills daily with patients seeking help with bumps and bruises, sore throats, and stuffy noses. But there’s an important difference about this clinic in central Alabama: No one gets a bill, including for prescriptions. That’s […]

The proponents of Proposition 35, a November ballot initiative that would create a dedicated stream of funding to provide health care for California’s low-income residents, have assembled an impressive coalition: doctors, hospitals, community clinics, dentists, ambulance companies, several county governments, numerous advocacy groups, big business, and both major political parties. The Yes on Prop 35 […]

Six weeks after an emergency cesarean section, with her newborn twins still in neonatal intensive care, Maya Gobara went to a pharmacy in West Little Rock, Arkansas, to fill a prescription. “The pharmacy told me I didn’t have insurance,” Gobara said. Arkansas is the only state that has not taken the step to expand what’s […]

SACRAMENTO, Calif. — California Gov. Gavin Newsom will soon decide whether the most populous U.S. state will join 25 others in regulating the middlemen known as pharmacy benefit managers, or PBMs, whom many policymakers blame for the soaring cost of prescription drugs. PBMs have been under fire for years for alleged profiteering and anticompetitive conduct, […]

SAN FRANCISCO — Andrew Douglass shoved his clothes and belongings into plastic trash bags as five police officers surrounded his encampment — a drab gray tent overflowing along a bustling sidewalk in the gritty Tenderloin neighborhood, where homeless people lie sprawled on public sidewalks, sometimes in drug overdoses. Officers gave him a choice: Go to […]

ATLANTA — On a recent summer evening, Raymia Taylor wandered into a recreation center in a historical downtown neighborhood, the only enrollee to attend a nearly two-hour event for people who have signed up for Georgia’s experimental Medicaid expansion. The state launched the program in July 2023, requiring participants to document that they’re working, studying, […]

WINDER, Ga. — About an hour after gunfire erupted at Apalachee High School, ambulances started arriving at nearby Northeast Georgia Medical Center Barrow with two students and two adults suffering from panic attacks and extreme anxiety, not bullet wounds. A fifth patient with similar symptoms later arrived at another local facility, according to a health […]

Forget repeal and replace. Critics of the Affordable Care Act, a.k.a. Obamacare, have a new target: key parts of the law that they say are too costly and provide incentive for fraud. Topping that list are the ACA’s enhanced subsidies, put in place during the coronavirus pandemic as part of economic recovery legislation and set to […]

KFF Health News and PolitiFact staffs Cuando la vicepresidenta Kamala Harris cruzó el escenario del debate el martes 10 por la noche para darle la mano al ex presidente Donald Trump, fue la primera vez que los dos se conocían en persona. Fue un breve y raro momento de cordialidad en un enfrentamiento marcado por […]

KFF Health News and PolitiFact staffs When Vice President Kamala Harris walked across the debate stage Tuesday night to shake the hand of former President Donald Trump, it was the first time the two had met in person. But that was the rare collegial moment in a face-off otherwise marked by false and sometimes bizarre […]

LOS ANGELES — For nearly a decade, John Baackes has led L.A. Care Health Plan, a publicly run insurer primarily serving low-income Los Angeles County residents on Medi-Cal. It is by far the largest Medi-Cal plan in the state. Baackes, 78, who will retire after the end of the year, helped transform L.A. Care into […]

The proportion of Americans without health insurance remained stable in 2023, the Census Bureau reported Tuesday, close to the record low the Biden administration achieved in 2022 through expansions of public programs, including the Affordable Care Act. About 8% of Americans were uninsured, a statistically insignificant increase of just 0.1 percentage point from a year […]

Julie Appleby, KFF Health News Suspicions that U.S. consumers’ personal information could be accessed from India led regulators to abruptly bar two large private sector enrollment websites from accessing the Affordable Care Act marketplace in August. New details about the suspensions come in legal filings made late Friday stemming from an effort by the two […]

A principios de 2022, Ashley y Kyle estaban recién casados, y emocionados porque esperaban su primer hijo. Pero desde el comienzo de su embarazo, Ashley había tenido hemorragias, y en julio, a las siete semanas, comenzó a tener un aborto espontáneo. Esto ocurrió unas semanas después que la Corte Suprema de Estados Unidos anulara el […]

The computer systems run by the consulting giant Deloitte that millions of Americans rely on for Medicaid and other government benefits are prone to errors that can take years and hundreds of millions of dollars to update. While states wait for fixes from Deloitte, beneficiaries risk losing access to health care and food. Changes needed […]

En medio de una amarga y divisiva contienda, el ex presidente Donald Trump y la vicepresidenta Kamala Harris solo parecen coincidir en una cosa: es tarea del gobierno reducir los altos precios de los medicamentos en el país. En 2022, Harris emitió el voto de desempate en el Senado para aprobar una ley que permite […]

Sarah Varney, KFF Health News Ashley and Kyle were newlyweds in early 2022 and thrilled to be expecting their first child. But bleeding had plagued Ashley from the beginning of her pregnancy, and in July, at seven weeks, she began miscarrying. The couple’s heartbreak came a few weeks after the U.S. Supreme Court overturned the […]

A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars — only to abruptly back off amid an “uproar” from the industry, newly released court filings show. The Centers for Medicare & Medicaid Services published the draft regulation in January 2014. The rule […]

Dan Weissmann Caitlyn Mai thought she did everything right. She called ahead to make sure her insurer would cover her cochlear implant surgery. She thought everything went according to plan but she still got a bill for the full cost of the surgery: more than $139,000.  What Caitlyn did next is a reminder of why […]

Former President Donald Trump and Vice President Kamala Harris have a rare point of agreement in their otherwise bitter and divisive contest: It’s up to the government to cut high U.S. drug prices. Harris cast the tie-breaking Senate vote in 2022 for legislation that allows Medicare to negotiate drug prices for its more than 60 […]

By Elisabeth Rosenthal August 26, 2024 Article HTML Elisabeth Rosenthal A hard-won provision of the Affordable Care Act allows young adults to stay on their family’s health insurance until age 26. But after that, those without employer-sponsored insurance face an array of complicated choices, including whether to shop on the insurance plan exchange, apply for […]

KFF Health News Midwest correspondent Bram Sable-Smith discussed the enduring trauma experienced by children who survived the Super Bowl parade shooting earlier this year on KMOX’s “Total Information AM” on Aug. 22. Click here to hear Sable-Smith on “Total Information AM” Read Sable-Smith and Peggy Lowe’s “Kids Who Survived Super Bowl Shooting Are Scared, Suffering […]

Federal regulators have blocked two private sector enrollment websites from accessing consumer information through the federal Obamacare marketplace, citing “anomalous activity.” The unusual step comes as the Centers for Medicare & Medicaid Services is under the gun to curb unauthorized enrollment and switching of Affordable Care Act plans by rogue agents. The agency received more […]

Jamie Holmes says a surgery center tried to make her pay for two operations after she underwent only one. She refused to buckle, even after a collection agency sued her last winter. Holmes, who lives in northwestern Washington state, had surgery in 2019 to have her fallopian tubes tied, a permanent birth-control procedure that her […]

Jacob Gardenswartz “As vice president, Kamala Harris cast the tie-breaking vote to cut, as you know, Medicare by $273 billion. She cast a vote to cut Medicare.”  — Former President Donald Trump at a July 24 campaign rally in Charlotte, North Carolina. During a July 24 campaign rally in Charlotte, North Carolina, former President Donald […]

Trisha Byers left behind one crucial item when she moved to North Carolina last year to be closer to her family after suffering a brain injury: health insurance. In Massachusetts, Byers, 39, was enrolled in Medicaid, the government health program that covers low-income people. But she was ineligible in North Carolina, which had not yet […]

The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to […]

The Affordable Care Act is back under attack. Not as in the repeal-and-replace debates of yore, but in a fresher take from Republican lawmakers who say key parts of the ACA cost taxpayers too much and provide incentive for fraud. Several House Republican leaders have called on two watchdog agencies to investigate, while Sen. Chuck […]

SAN RAFAEL, Calif. — When Bobby Moske went to a community clinic a few years ago with a toothache, he couldn’t find a dentist in Marin County willing to take Medicaid to do a root canal. Marin Community Clinics referred the 75-year-old to a dentist about 20 miles away in San Francisco, but his tooth […]

For Roderick Givens, a radiation oncologist, the expansion of Medicaid isn’t just a policy issue. He practices medicine in a rural area in the Mississippi Delta and he sees daily how Medicaid coverage could help his uninsured patients. “I can’t tell you the number of patients who I see who come in with advanced disease, […]

Stephanie Armour Vice President Kamala Harris “endorsed free taxpayer-funded government health care for all illegal aliens.” Former President Donald Trump, July 24, in a speech at a rally in Charlotte, North Carolina. Attacking Vice President Kamala Harris on immigration, Republicans and allies of former Donald President Trump’s are saying the presumptive Democratic presidential candidate supported […]

The National Education Association, the nation’s largest union, is threatening to cut off health insurance to about 300 Washington, D.C.-based workers on Aug. 1 in an effort to end a bitter contract dispute. It’s a tactic some private employers have used as leverage against unionized workers that has drawn scrutiny from congressional Democrats and is […]

Health insurance agents who fraudulently enroll consumers in Affordable Care Act health plans could be subject to criminal charges — and civil penalties of $10,000 to $200,000 — under legislation introduced Wednesday by Sen. Ron Wyden (D-Ore.), chairman of the powerful Senate Finance Committee. Wyden first promised the bill in May, when he called on […]

A lo largo de su presidencia, Joe Biden se apoyó en Kamala Harris, la ex fiscal y senadora frontal que eligió como vicepresidenta, para ser la voz de apoyo inquebrantable de la Casa Blanca en favor de los derechos de salud reproductiva. Ahora, mientras los demócratas reconstruyen su candidatura presidencial a pocos meses de las […]

Throughout Joe Biden’s presidency, he leaned on the outspoken former prosecutor and senator he selected as his vice president, Kamala Harris, to be the White House’s voice of unflinching support for reproductive health rights. Now, as Democrats rebuild their presidential ticket just a few months before Election Day, Harris would widely be expected to take […]

No talk of Obamacare. Or abortion. At the Republican National Convention in Milwaukee this week, where delegates officially nominated Donald Trump as the party’s 2024 presidential candidate, health care issues received little attention from prime-time speakers. The silence is surprising, given health care makes up the largest chunk of the federal budget, nearly $2 trillion, […]

Julie Appleby, KFF Health News The Biden administration on Friday put in place stringent curbs aimed at thwarting rogue insurance brokers from switching consumers’ Affordable Care Act plans without their consent. The announcement came in response to mounting complaints from consumers. The Centers for Medicare & Medicaid Services said Friday that, in the first six […]

Ni una palabra sobre el Obamacare o el aborto. En la Convención Nacional Republicana en Milwaukee esta semana, donde los delegados nominaron oficialmente a Donald Trump como candidato presidencial del partido para 2024, los oradores principales le dieron poco lugar a los temas de atención médica. Este silencio es sorprendente, dado que la atención médica […]

The government is giving away money! So say ads on a variety of social media platforms. Consumers, the ads claim, can qualify for $1,400 or even $6,400 a month to use on groceries, rent, medical expenses, and other bills. Some mention no-cost health insurance coverage. But that’s not the whole story. And here’s the spoiler […]

Caitlyn Mai woke up one morning in middle school so dizzy she couldn’t stand and deaf in one ear, the result of an infection that affected one of her cranial nerves. Though her balance recovered, the hearing never came back. Growing up, she learned to cope — but it wasn’t easy. With only one functioning […]

Dan Weissmann Hospital facility fees. They can feel like a charge just for walking in the door. Hospitals say they go toward overhead on facilities with lots of specialized equipment and staff, like emergency rooms. But these fees have grown and become more common in recent years. And as hospitals buy up outpatient facilities, patients […]

The largest private company that brokers use to enroll people in Affordable Care Act health plans said it’s joining with insurers to thwart unauthorized Obamacare sign-ups and plan switches. HealthSherpa, which has its own sales team, announced the new initiative — called “Member Defense Network” — July 16. It will cut off commissions for unscrupulous […]

SACRAMENTO — When then-Gov. Arnold Schwarzenegger called for nearly all Californians to buy health insurance or face a penalty, Anthony Wright slammed the 2007 proposal as “unwarranted, unworkable, and unwise” — one that would punish those who could least afford coverage. The head of Health Access California, one of the state’s most influential consumer groups, […]

Over three decades of relentless pain, Jonna Tallant has tried about every TMJ treatment: mouthguards, six sets of braces, dental crowns and appliances, drugs, physical therapy, Botox, massage, acupuncture, chiropractic care, and surgery. Nothing has helped. Tallant, 51, of Knoxville, Tennessee, said she lives in agony and cannot eat any food that must be chewed. […]

David Engler had been pretty sure he didn’t want children. Then a frustrating school day two years ago helped seal the deal for the now 43-year-old substitute teacher. “It was wild. I had to call the office seven times to get kids pulled out,” he said. “The next day, I called Kaiser and said, ‘I’d […]

What weighs most heavily on older adults’ minds when it comes to health care? The cost of services and therapies, and their ability to pay. “It’s on our minds a whole lot because of our age and because everything keeps getting more expensive,” said Connie Colyer, 68, of Pleasureville, Kentucky. She’s a retired forklift operator […]

Dan Weissmann Some people who expected their health insurance to cover some out-of-network care have been getting stuck with enormous bills. One Kansas City, Kansas, couple paid thousands of dollars out-of-pocket and up-front for care. They expected to get a partial reimbursement from their insurer. So, they were shocked when instead they got a bill […]

Arizona and Florida — whose rates of uninsured children are among the highest in the nation — set goals last year to widen the safety net that provides health insurance to people 18 and younger. But their plans to expand coverage illustrate key ideological differences on the government’s role in subsidizing health insurance for kids: […]

Peggy Lowe, KCUR and Bram Sable-Smith Abigail Arellano keeps her son Samuel’s medical bills in a blue folder in a cabinet above the microwave. Even now, four months after the 11-year-old was shot at the Kansas City Chiefs Super Bowl parade, the bills keep coming. There’s one for $1,040 for the ambulance ride to the […]

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Abigail Arellano tiene todas las facturas médicas de su hijo Samuel en una carpeta azul en un armario arriba del microondas. Incluso ahora, cuatro meses después que el niño de 11 años fuera herido de bala en el desfile del Super Bowl de los Kansas City Chiefs, las facturas siguen llegando. Hay una de $1,040 […]

The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to […]

Gov. Gavin Newsom, state lawmakers, and health industry leaders have a small window to reach an agreement on billions of new dollars for Medi-Cal before it’s put to voters in November. An initiative, supported by virtually every sector of the state’s health care industry as well as the local Republican and Democratic parties, would lock […]

Arizona and Florida lawmakers saw trouble ahead for children in 2023, with states slated — as the covid-19 pandemic waned — to resume disenrolling ineligible people from Medicaid. So, legislators in both states voted to expand a safety net known as the Children’s Health Insurance Program, or CHIP, which covers those 18 and younger in […]

Jacob Gardenswartz If the Affordable Care Act were terminated, “that would mean over a hundred million Americans will lose protections for preexisting conditions.” President Joe Biden in a campaign advertisement, May 8 President Joe Biden’s reelection campaign wants voters to contrast his record on health care policy with his predecessor’s. In May, Biden’s campaign began […]

Months into a new Biden administration policy intended to lower drug costs for Medicare patients, independent pharmacists say they’re struggling to afford to keep some prescription drugs in stock. “It would not matter if the governor himself walked in and said, ‘I need to get this prescription filled,’” said Clint Hopkins, a pharmacist and co-owner […]

KFF Health News senior fellow and editor-at-large for public health Céline Gounder discussed the consequences of restrictive and unclear abortion laws on CBS’ “CBS Mornings” on June 4. Gounder also discussed a recent report that found pollution is a greater health threat than war, terrorism, addiction, or disease on CBS News 24/7’s “The Daily Report” […]

California’s Office of Health Care Affordability faces a herculean task in its plan to slow runaway health care spending. The goal of the agency, established in 2022, is to make care more affordable and accessible while improving health outcomes, especially for the most disadvantaged state residents. That will require a sustained wrestling match with a […]

Dan Weissmann Medicaid — the state-federal health insurance program for low-income and disabled Americans — has cut more than 22 million recipients since spring 2023. One of them was the son of Ashley Eades. Her family lost their Medicaid coverage in the “unwinding” of protections that had barred states from dropping people for years during […]

When Cassie Cox ended up in the emergency room in January, the Bainbridge, Georgia, resident was grateful for the Obamacare insurance policy she had recently selected for coverage in 2024. Cox, 40, qualified for an Affordable Care Act marketplace plan with no monthly premium due to her relatively low income. And after she cut her […]

Lawmakers and state officials are turning up the heat on federal regulators to stop unscrupulous, commission-hungry insurance agents from enrolling thousands of people in Affordable Care Act plans, or switching their coverage, without their knowledge. Customers often don’t discover the changes until they’re denied medical coverage or get stuck with a bill for ACA tax […]

The Host With abortion shaping up as a key issue for the November elections, the movement that united to overturn Roe v. Wade is divided over going further, faster — including by punishing those who have abortions and banning contraception or IVF. Politicians who oppose abortion are already experiencing backlash in some states. Meanwhile, bad […]

GRASS VALLEY, Calif. — Here in the rugged foothills of California’s Sierra Nevada, the streets aren’t littered with needles and dealers aren’t hustling drugs on the corner. But meth is almost as easy to come by as a hazy IPA or locally grown weed. Quinn Coburn knows the lifestyle well. He has used meth most […]

Vincent Wasney and his fiancée, Sarah Eberlein, had never visited the ocean. They’d never even been on a plane. But when they bought their first home in Saginaw, Michigan, in 2018, their real estate agent gifted them tickets for a Royal Caribbean cruise. After two years of delays due to the coronavirus pandemic, they set […]

Angling to tap into strong support for the sweeping health law he helped pass 14 years ago, one of President Joe Biden’s latest reelection strategies is to remind voters that former President Donald Trump tried to repeal the Affordable Care Act. “Folks, he’s coming for your health care, and we’re not going to let it […]

Stronger actions are needed immediately to thwart insurance brokers who fraudulently enroll or switch people in Affordable Care Act coverage, Sen. Ron Wyden, chairman of the powerful Senate Finance Committee, said Monday. “We want the Centers for Medicare & Medicaid Services to hold these brokers criminally responsible for ripping people off this way,” he told […]

About a year into the process of redetermining Medicaid eligibility after the covid-19 public health emergency, more than 20 million people have been kicked off the joint federal-state program for low-income families. A chorus of stories recount the ways the unwinding has upended people’s lives, but Native Americans are proving particularly vulnerable to losing coverage […]

TURLOCK, Calif. — For much of his young life, Jorge Sanchez regularly gasped for air, at times coughing so violently that he’d almost throw up. His mother whisked him to the emergency room late at night and slept with him to make sure he didn’t stop breathing. “He’s had these problems since he was born, […]

Jacqueline Saa has a genetic condition that leaves her unable to stand and walk on her own or hold a job. Every weekday for four years, Saa, 43, has relied on a home health aide to help her cook, bathe and dress, go to the doctor, pick up medications, and accomplish other daily tasks. She […]

Millions of people were surprised to find themselves booted from Medicaid over the past year after pandemic-era protections expired that had prevented states from terminating their coverage. Turns out, millions of them were also unaware they had been covered by the government program. Nearly 1 in 3 people enrolled in Medicaid in 2022 — or […]

The Host A new analysis finds that graduating medical students were less likely to apply this year for residency training in states that ban or restrict abortion. That was true not only for aspiring OB-GYNs and others who regularly treat pregnant patients, but for all specialties. Meanwhile, another study has found that more than 4 […]

President Joe Biden counts among his accomplishments the record-high number of people, more than 21 million, who enrolled in Obamacare plans this year. Behind the scenes, however, federal regulators are contending with a problem that affects people’s coverage: rogue brokers who have signed people up for Affordable Care Act plans, or switched them into new […]

Marisol Pantoja Toribio se encontró un bulto en el pecho a principios de enero. Sin seguro y viviendo en California sin papeles, y sin su familia, la normalmente despreocupada mujer de 43 años se dio cuenta pronto de lo limitadas que eran sus opciones. “Yo dije, ¿Qué voy a hacer? …. “, recordó emocionada. Inmediatamente le […]

Marisol Pantoja Toribio found a lump in her breast in early January. Uninsured and living in California without legal status and without her family, the usually happy-go-lucky 43-year-old quickly realized how limited her options were. “I said, ‘What am I going to do?’” she said in Spanish, quickly getting emotional. She immediately worried she might […]

Samantha Young Oregon is shipping air conditioners, air purifiers, and power banks to some of its most vulnerable residents, a first-in-the-nation experiment to use Medicaid money to prevent the potentially deadly health effects of extreme heat, wildfire smoke, and other climate-related disasters. The equipment, which started going out in March, expands a Biden administration strategy […]

Cass Smith-Collins jumped through hoops to get the surgery that would match his chest to his gender. Living in Las Vegas and then 50, he finally felt safe enough to come out as a transgender man. He had his wife’s support and a doctor’s letter showing he had a long history of gender dysphoria, the […]

Phil Galewitz, KFF Health News Private Medicaid health plans lost millions of members in the past year as pandemic protections that prohibited states from dropping anyone from the government program expired. But despite Medicaid’s unwinding, as it’s known, at least two of the five largest publicly traded companies selling plans have continued to increase revenue […]

In the 2020 elections, then-candidate Joe Biden and many of his congressional colleagues loudly advocated for a federal “public option” health insurance plan. It was framed, at the time, as part of his incoming administration’s response to the pandemic. “Low-income Americans will be automatically enrolled in the public option at zero cost to them, though […]

The Biden administration wants to make it easier for Americans to get dental care. But don’t try booking an appointment just yet. A new regulation out this month allows states to include adult dental care as a benefit that health insurers must cover under the Affordable Care Act. Following record ACA enrollment this year, the proposal represents an […]

Kate Ruder DENVER — Pediatrician Patricia Braun and her team saw roughly 100 children at a community health clinic on a recent Monday. They gave flu shots and treatments for illnesses like ear infections. But Braun also did something most primary care doctors don’t. She peered inside mouths searching for cavities or she brushed fluoride […]

Nearly a decade ago, Medicare launched a program to help the two-thirds of beneficiaries with chronic conditions by paying their doctors an additional monthly fee to coordinate their care. The strategy has largely failed to live up to its potential; only about 4 percent of potentially eligible beneficiaries in the traditional Medicare program are enrolled, […]

Aaron Bolton, MTPR KALISPELL, Mont. — On a cold February morning at the Flathead Warming Center, Tashya Evans waited for help with her Medicaid application as others at the shelter got ready for the day in this northwestern Montana city. Evans said she lost Medicaid coverage in September because she hadn’t received paperwork after moving […]

SACRAMENTO, Calif. — California state lawmakers this year are continuing their progressive tilt on health policy with dozens of proposals including a ban on a Froot Loops ingredient and free condoms for high schoolers. As states increasingly fracture along partisan lines, California Democrats are stamping their supermajority on legislation that they will consider until they […]

Two months after a cyberattack on a UnitedHealth Group subsidiary halted payments to some doctors, medical providers say they’re still grappling with the fallout, even though UnitedHealth told shareholders on Tuesday that business is largely back to normal. “We are still desperately struggling,” said Emily Benson, a therapist in Edina, Minnesota, who runs her own […]

The Host Mary Agnes Carey KFF Health News @maryagnescarey Read Mary Agnes’ stories. Lawmakers in Washington this week held the first congressional hearing on the Change Healthcare cyberattack, a breach that sent shock waves through the health care system as payments for care ground to a halt and left some providers in financial trouble. Republicans […]

A wide-ranging lawsuit filed Friday outlines a moneymaking scheme by which large insurance sales agency call centers enrolled people into Affordable Care Act plans or switched their coverage, all without their permission. According to the lawsuit, filed in U.S. District Court for the Southern District of Florida, two such call centers paid tens of thousands […]

Casi una cuarta parte de los adultos que fueron dados de baja de Medicaid el año pasado dicen que ahora no tienen seguro, según una encuesta que detalla cómo decenas de millones de estadounidenses lucharon por conservar la cobertura del gobierno para personas de bajos ingresos. Las protecciones que tuvo el programa durante la pandemia, […]

Tax season is never fun. But some tax filers this year face an added complication: Their returns are being rejected because they failed to provide information about Affordable Care Act coverage they didn’t even know they had. While the concern about unscrupulous brokers enrolling unsuspecting people in ACA coverage has simmered for years, complaints have […]

Nearly a quarter of adults disenrolled from Medicaid in the past year say they are now uninsured, according to a survey released Friday that details how tens of millions of Americans struggled to retain coverage in the government insurance program for low-income people after pandemic-era protections began expiring last spring. The first national survey of […]

DENVER.- Un lunes reciente, la pediatra Patricia Braun y su equipo atendieron a unos 100 niños en una clínica comunitaria. Administraron vacunas contra la gripe y trataron infecciones de oído. Pero Braun también hizo algo que la mayoría de los médicos de atención primaria no hacen. Revisó las bocas de los pacientes en busca de […]

Dan Weissmann Covering the American health care system means we tell some scary stories. This episode of “An Arm and a Leg” sounds like a real horror movie.  It uses one of Hollywood’s favorite tropes: machines taking over. And the machines belong to the private health insurance company UnitedHealth Group.  Host Dan Weissmann talks to […]

Until last week, the system that is used to enroll people in federal Affordable Care Act insurance plans inadvertently allowed access by insurance brokers to consumers’ full Social Security numbers, information brokers don’t need. That raised concerns about the potential for misuse. The access to policyholders’ personal information was one of the problems cited in […]

Federal and state regulators aren’t doing enough to stop the growing problem of rogue health insurance brokers making unauthorized policy switches for Affordable Care Act policyholders, say consumers, agents, nonprofit enrollee assistance groups, and other insurance experts. “We think it’s urgent and it requires a lot more attention and resources,” said Jennifer Sullivan, director of […]

KFF Health News senior fellow and editor-at-large for public health Céline Gounder discussed bird flu on CBS News’ “CBS Mornings” on April 2. Click here to watch Gounder on “CBS Mornings” El Tímpano reporter Jasmine Aguilera, who has been reporting in collaboration with KFF Health News and California Healthline, discussed how Hispanic communities are affected […]

Samantha Putterman, PolitiFact Insulin for Medicare beneficiaries “was costing 400 bucks a month on average. It now costs $35 a month.” President Joe Biden, in a March 22 speech The cost of insulin in the United States has risen considerably in recent years, with some estimates finding that Americans have paid around 10 times as […]

Michelle Andrews Companies have increasingly offered generous fertility benefits to attract and keep top-notch workers. Now, the federal government is getting in on the act. Starting this year, federal employees can choose plans that cover several fertility services, including up to $25,000 annually for in vitro fertilization procedures and up to three artificial insemination cycles […]

The Biden administration faces what looks like a growing problem for the federal Affordable Care Act’s insurance exchange: disreputable insurance brokers enrolling people who don’t need coverage or switching them to new plans without their authorization. It happened to Michael Debriae, a restaurant server who lives in Charlotte. Unbeknownst to him, an agent in Florida […]

Work requirements in Medicaid expansion programs are back on the agenda in many statehouses — despite their lackluster track record. In Mississippi, the idea has momentum from GOP lawmakers advancing legislation to expand Medicaid. In Kansas, the Democratic governor proposed work requirements to try to soften Republican opposition to expansion. (She’s had little luck, so […]

En enero, Susanne Gilliam, de 67 años, estaba yendo a recoger el correo afuera de su casa cuando se cayó al resbalar sobre una capa de hielo negro. Sintió una punzada de dolor en la rodilla y el tobillo de la pierna izquierda. Después de llamar a su marido por teléfono, logró regresar a su […]

Julie Appleby, KFF Health News Some consumers covered by Affordable Care Act insurance plans are being switched from one plan to another without their express permission, potentially leaving them unable to see their doctors or fill prescriptions. Some face large IRS bills for back taxes. Share Your Story Do you have experience with ACA plan-switching […]

Cuando estaba en noveno grado, Fiona Lu cayó en una depresión. Tenía problemas para adaptarse a su nueva escuela en Orange County, California, y se sentía tan aislada y agotada que lloraba todas las mañanas. Lu quería recibir ayuda, pero su plan de Medi-Cal no cubría la terapia a menos que tuviera el permiso de […]

Susanne Gilliam, 67, was walking down her driveway to get the mail in January when she slipped and fell on a patch of black ice. Pain shot through her left knee and ankle. After summoning her husband on her phone, with difficulty she made it back to the house. And then began the run-around that […]

Bart Klion, 95, and his wife, Barbara, faced a tough choice in January: The upstate New York couple learned that this year they could keep either their private, Medicare Advantage insurance plan — or their doctors at Saratoga Hospital. The Albany Medical Center system, which includes their hospital, is leaving the Klions’ Humana plan — […]

The Host In its first abortion case since the overturning of Roe v. Wade in 2022, the Supreme Court this week looked unlikely to uphold an appeals court ruling that would dramatically restrict the availability of the abortion pill mifepristone. But the court already has another abortion-related case teed up for April, and abortion opponents […]

When she was in ninth grade, Fiona Lu fell into a depression. She had trouble adjusting to her new high school in Orange County, California, and felt so isolated and exhausted that she cried every morning. Lu wanted to get help, but her Medi-Cal plan wouldn’t cover therapy unless she had permission from a parent […]

Jason George began noticing in September that Medicaid payments had stalled for some of his assisted living facility residents, people who need help with daily living. Guardian Group Montana, which owns three small facilities in rural Montana, relies on the government health insurance to cover its care of low-income residents. George, who manages the facilities, […]

Christian Espinoza, director de operaciones de una red de clínicas de tratamiento del sur de California, comenzó recientemente a emplear un nuevo asistente poderoso: un algoritmo de inteligencia artificial (IA) que puede realizar exámenes de la vista con imágenes tomadas por una cámara retinal. Realiza diagnósticos rápidos, sin la presencia de un médico. Sus clínicas, […]

Sara England was putting together Ghostbusters costumes for Halloween when she noticed her baby wasn’t doing well. Her 3-month-old son, Amari Vaca, had undergone open-heart surgery two months before, so she called his cardiologist, who recommended getting him checked out. England assigned Amari’s grandparents to trick-or-treat duty with his three older siblings and headed to […]

Amy Sherman, PolitiFact We cut the federal deficit by $160 billion because Medicare will no longer have to pay those exorbitant prices to Big Pharma. President Joe Biden in his State of the Union address, March 7, 2024 President Joe Biden has been making his case for reelection to voters by telling them he is […]

OAKLAND, California – El Medi-Cal llegó a Antonio Abundis cuando el conserje más lo necesitaba. Poco después que Abundis pasara de tener cobertura limitada a una cobertura completa en 2022, bajo la expansión del Medi-Cal de California para adultos mayores sin papeles, fue diagnosticado con leucemia, un tipo de cáncer que afecta las células de […]

OAKLAND, Calif. — Medi-Cal health coverage kicked in for Antonio Abundis just when the custodian needed it most. Shortly after Abundis transitioned from limited to full-scope coverage in 2022 under California’s expansion of Medi-Cal to older residents without legal immigration status, he was diagnosed with leukemia, a cancer affecting the blood cells. The soft-spoken father […]

The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to […]

Durante el boom de la telemedicina por la pandemia de covid-19, surgieron tiendas online que promocionaban la testosterona como remedio para las afecciones masculinas relacionadas con la edad, a pesar de las normas de la Administración de Drogas y Alimentos (FDA) emitidas hace años que restringen este tipo de publicidad sobre “testosterona baja”. En anuncios […]

There’s a long-running battle between insurers and drugmakers over financial assistance programs that purport to help patients afford expensive drugs. And lately, insurers have been losing ground as lawmakers, regulators and courts weigh in. The issue is whether coupons and other copay aid many patients get from drugmakers should count toward annual insurance deductibles and […]

Georgia Gov. Brian Kemp’s plan for a conservative alternative to Obamacare’s Medicaid expansion has cost taxpayers at least $26 million so far, with more than 90% going toward administrative and consulting costs rather than medical care for low-income people. Kemp’s Georgia Pathways to Coverage offers government health insurance to people earning up to the federal […]

The Biden administration has hit on a strategy to deal with the massive, industry-paralyzing cyberattack on a UnitedHealth Group unit: pressuring insurers to fix it. Federal officials have been in constant conversation with senior leaders at UnitedHealth and across the industry, including at a Monday meeting where Department of Health and Human Services and White […]

Sarah Feldman, de 35 años, recibió las primeras cartas amenazantes del Centro Médico Mount Sinai en noviembre pasado. El sistema hospitalario de Nueva York le advirtió que tenía problemas para negociar un acuerdo de precios con UnitedHealthcare, que incluye los planes de salud de Oxford, la aseguradora de Feldman. “Estamos trabajando de buena fe con […]

Billy Abbott, a retired Army medic, wakes at 6 every morning, steps on the bathroom scale, and uses a cuff to take his blood pressure. The devices send those measurements electronically to his doctor in Gulf Shores, Alabama, and a health technology company based in New York, to help him control his high blood pressure. […]

Sarah Feldman, 35, received the first ominous letters from Mount Sinai Medical last November. The New York hospital system warned it was having trouble negotiating a pricing agreement with UnitedHealthcare, which includes Oxford Health Plans, Feldman’s insurer. “We are working in good faith with Oxford to reach a new fair agreement,” the letter said, continuing […]

In early 2019, Jennifer Hepworth and her husband were stunned by a large bill they unexpectedly received for their daughter’s prescription cystic fibrosis medication. Their payment had risen to $3,500 from the usual $30 for a month’s supply. That must be a mistake, she told the pharmacy. But it wasn’t. It turned out that the […]

The Host The general election campaign for president is (unofficially) on, as President Joe Biden and former President Donald Trump have each apparently secured enough delegates to become his respective party’s nominee. And health care is turning out to be an unexpectedly front-and-center campaign issue, as Trump in recent weeks has suggested he may be […]

April Dembosky, KQED A much-awaited treatment for postpartum depression, zuranolone, hit the market in December, promising an accessible and fast-acting medication for a debilitating illness. But most private health insurers have yet to publish criteria for when they will cover it, according to a new analysis of insurance policies. The lack of guidance could limit […]

Dan Weissmann Medicare may sound like an escape from the expensive world of U.S. health insurance, but it’s more complicated, and expensive, than many realize. And decisions seniors make when they sign up for the federal health insurance program can have huge consequences down the road.  Host Dan Weissmann speaks with Sarah Jane Tribble, KFF […]

Margaret Parsons, one of three dermatologists at a 20-person practice in Sacramento, California, is in a bind. Since a Feb. 21 cyberattack on a previously obscure medical payment processing company, Change Healthcare, Parsons said, she and her colleagues haven’t been able to electronically bill for their services. She heard Noridian Healthcare Solutions, California’s Medicare payment […]

President Joe Biden touted his administration’s accomplishments in health care in a wide-ranging State of the Union address on Thursday evening that touched on subjects such as immigration, the economy, crime, job growth, infrastructure, and the Israel-Hamas war.  With Biden and former President Donald Trump now the presumptive Democratic and Republican nominees, Biden used the […]

The Host Julie Rovner KFF Health News @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to […]

A Maryland firm that oversees the nation’s largest independent network of primary care medical practices is facing a whistleblower lawsuit alleging it cheated Medicare out of millions of dollars using billing software “rigged” to make patients appear sicker than they were. The civil suit alleges that Aledade Inc.’s billing apps and other software and guidance […]

KFF Health News senior correspondent Aneri Pattani discussed how Mobile, Alabama, is weighing whether to use opioid settlement funds to pay treatment costs now or invest in long-term solutions to cut future addiction rates on NPR’s “Morning Edition” on Feb. 27. Click here to hear Pattani on “Morning Edition” Read Pattani’s series, “Payback: Tracking the […]

Darius Tahir Early in the morning of Feb. 21, Change Healthcare, a company unknown to most Americans that plays a huge role in the U.S. health system, issued a brief statement saying some of its applications were “currently unavailable.” By the afternoon, the company described the situation as a “cyber security” problem. Since then, it […]

Judith Graham It was an every-other-day routine, full of frustration. Every time my husband called his father, who was 94 when he died in 2022, he’d wait for his dad to find his hearing aids and put them in before they started talking. Even then, my father-in-law could barely hear what my husband was saying. […]

Debra Prichard was a retired factory worker who was careful with her money, including what she spent on medical care, said her daughter, Alicia Wieberg. “She was the kind of person who didn’t go to the doctor for anything.” That ended last year, when the rural Tennessee resident suffered a devastating stroke and several aneurysms. […]

Mary Delgado’s first pregnancy went according to plan, but when she tried to get pregnant again seven years later, nothing happened. After 10 months, Delgado, now 34, and her partner, Joaquin Rodriguez, went to see an OB-GYN. Tests showed she had endometriosis, which was interfering with conception. Delgado’s only option, the doctor said, was in […]

For more than a decade, some Southern states have resisted Medicaid expansion under the Affordable Care Act, even though data suggest it could help their residents. Today, the large majority of uninsured Americans who would gain coverage under Medicaid expansion — and who would benefit from affordable access to care — live in non-expansion states […]

For weeks, more than half a million Anthem Blue Cross enrollees who receive health care from the University of California were held in suspense. It wasn’t clear whether they would have to find new doctors or switch plans as the health system and one of its largest insurance partners struggled to reach agreement on a […]

Last year alone, David Mitchell paid $16,525 for 12 little bottles of Pomalyst, one of the pricey medications that treat his multiple myeloma, a blood cancer he was diagnosed with in 2010. The drugs have kept his cancer at bay. But their rapidly increasing costs so infuriated Mitchell that he was inspired to create an […]

Daniel Chang and Andy Miller As a part-time customer service representative, Jolene Dybas earns less than $15,000 a year, which is below the federal poverty level and too low for her to be eligible for subsidized health insurance on the Obamacare marketplace. Dybas, 53, also does not qualify for Medicaid in her home state of […]

Last month, my colleague Lauren Sausser told you about the Biden administration’s crackdown on insurance plans’ prior authorization policies, with new rules for certain health plans participating in federal programs such as Medicare Advantage or the Affordable Care Act marketplace. States are getting in on the action, too. Prior authorization, sometimes called pre-certification, requires patients […]

Nothing melts our hearts like a health policy valentine. Readers made us swoon this season, writing poetic lines about prescription drug pricing, medical debt, primary care shortages, and more.  Here are some of our favorites, starting with the grand prize winner and first runner-up, whose entries were each turned into a cartoon by staff illustrator […]

The No Surprises Act, the landmark law intended to protect patients from surprise out-of-network medical bills, has come with, well, some surprises. A little more than two years after it took effect, there’s good and bad news about how it’s working. First, it’s important to note that the law has successfully protected millions of patients […]

In the battle to control health care costs, hospitals are deploying their political power to protect their bottom lines. The point of contention: For decades, Medicare has paid hospitals — including hospital-owned physician practices that may not be physically located in a hospital building — about double the rates it pays other doctors and facilities […]

Bram Sable-Smith Christopher Marks noticed an immediate improvement when his doctor prescribed him the Type 2 diabetes medication Mounjaro last year. The 40-year-old truck driver from Kansas City, Missouri, said his average blood sugar reading decreased significantly and that keeping it within target range took less insulin than before. But when his doctor followed the […]

Estados están invirtiendo miles de millones de dólares en un experimento de atención médica de alto riesgo: utilizar fondos ya escasos de seguros de salud públicos para proporcionar vivienda a los estadounidenses más pobres y enfermos. California está liderando esta tendencia, destinando gran parte de un presupuesto de $12 mil millones a una ambiciosa iniciativa […]