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It is a perilous time to throw low- and middle-income Americans off the insurance cliff: A new omicron subvariant is spreading, and a program that provided coronavirus testing and covid-19 treatment at no cost to the uninsured has expired.
The Biden administration unveiled a new special enrollment option aimed at signing up low-income Americans for Affordable Care Act coverage 鈥 even if it is outside of the usual annual open enrollment period. But insurers are cutting broker commissions at the same time.
The pandemic crisis has overwhelmed understaffed state Medicaid agencies, already delaying access to the insurance program in Missouri. As the public health emergency ends, low-income people nationwide could find it even harder to have coverage.
In his proposed budget, President Joe Biden called for a boost in health spending that includes billions of dollars to prepare for a future pandemic. But that doesn鈥檛 include money he says is needed immediately for testing and treating covid-19. Also this week, federal regulators authorized a second booster shot for people 50 and older yet gave little guidance to consumers about who needs the shot and when. Amy Goldstein of The Washington Post, Jennifer Haberkorn of the Los Angeles Times, and Rachana Pradhan of KHN join KHN鈥檚 Mary Agnes Carey to discuss these issues and more. Plus, Julie Rovner interviews KHN鈥檚 Julie Appleby, who reported and wrote the latest KHN-NPR 鈥淏ill of the Month鈥 episode about a very expensive 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.
The No Surprises Act offers protection from many surprise medical bills 鈥 but that protection may be only as good as a patient鈥檚 knowledge of the law and ability to make sure it鈥檚 enforced. Here鈥檚 what you need to know.
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鈥檚 proposed reimbursement rate, which is below what most other states pay.
Many Medicare Advantage plans send caregivers to the homes of seniors periodically to help with housework and provide companionship. But the workers may also prod seniors into activities that boost the plans鈥 Medicare ratings and federal reimbursements.
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.
Private and public employers are increasingly using the government鈥檚 Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the 鈥渙verwhelming majority鈥 of medical costs, according to an industry analyst.
The failure of single-payer health care legislation in California casts doubt on the ability of other states to pass government-run, universal health care. But activists in New York, Washington state, and elsewhere say they are taking lessons from California and changing their tactics.
After a years-long bitter partisan fight over reforming the U.S. Postal Service鈥檚 finances and service, congressional leaders say they have a compromise. The bill, which has won endorsements from both Republicans and Democrats on Capitol Hill, would force future Postal Service retirees to use Medicare as their primary source of health coverage.
After a troubled start to the new Medi-Cal prescription drug program, the state鈥檚 contractor has hired staffers to reduce wait times for medication approvals and patients seeking help. But some doctors and clinics report that patients continue to face delays.
In anticipation of the Supreme Court rolling back abortion rights this year, both Democrats and Republicans are arguing among themselves over how best to proceed to either protect or restrict the procedure. Meanwhile, millions of Americans are at risk of losing their health insurance when the federal government declares an end to the current 鈥減ublic health emergency.鈥 Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Rachana Pradhan of KHN join KHN鈥檚 Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KHN鈥檚 Jay Hancock, who wrote the latest KHN-NPR 鈥淏ill of the Month鈥 episode about a couple whose insurance company deemed their twins鈥 stay in intensive care not an emergency.
The insurance company said that the birth of the Bull family鈥檚 twins was not an emergency and that NICU care was 鈥渘ot medically necessary.鈥 The family鈥檚 experience with a huge bill sent to collections happened in 2020, but it exposes a hole in the new No Surprises law that took effect Jan. 1.
Washington was the first state in the U.S. to introduce a public option for health insurance, but the rollout hasn鈥檛 been smooth. Other states with public options in the works are taking notice.
Missouri has more people waiting to have their Medicaid applications processed than it has approved since the expansion of the federal-state health insurance program. Although most states process Medicaid applications within a week, Missouri is taking, on average, more than two months. Patient advocates fear that means people will stay uninsured longer, leading them to postpone care or get stuck with high medical bills.
Service dogs can help people with ailments from autism to epilepsy, but a trained dog can cost up to $40,000 鈥 and insurance won鈥檛 cover it.
State Medicaid agencies for months have been preparing for the end of a federal mandate that has prevented states from removing people from the safety-net program during the pandemic.
KHN highlights some of the creative valentines posted on Twitter by health policy enthusiasts.
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