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Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest. As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist in Los Angeles recommended the 67-year-old undergo…

Planes de salud de Medicaid intentan proteger a sus miembros… y a sus ganancias

Las protecciones federales por la pandemia de covid-19, que desde 2020 prohibieron a los estados eliminar a beneficiarios de Medicaid, incluso si ya no calificaban, lograron bajar el número de personas sin seguro de salud a un mínimo histórico. También…

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

Eli Lilly & Co.’s announcement that it is slashing prices for its major insulin products could make life easier for some diabetes patients while easing pressure on Big Pharma. It also casts light on the profiteering methods of the drug…

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

The federal covid-19 pandemic protections that have largely prohibited states from dropping anyone from Medicaid since 2020 helped millions of low-income Americans retain health insurance coverage — even if they no longer qualified — and brought the U.S. uninsured rate…

March Medicaid Madness

The Host Julie Rovner KHN @jrovner Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KHN’s weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the…

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

Newborns. Former inmates. College students. Expectant moms. People with disabilities. Foster kids. Homeless people. Single dads. Your neighbor. Your co-worker. You. California’s Medicaid program, called Medi-Cal, serves a whopping 15.4 million people, offering care from cradle to grave: Half of…

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

PERRY, Iowa — Fran Ruhl’s family received a startling letter from the Iowa Department of Human Services four weeks after she died in January 2022. “Dear FAMILY OF FRANCES RUHL,” the letter began. “We have been informed of the death…

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

Most lawmakers — Republicans and Democrats alike — have declared the marquee safety-net programs of Medicare and Social Security off-limits for cuts as a divided Washington heads for a showdown over the national debt and government spending. Health programs for…

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

During the first two years of the covid-19 pandemic, while the federal government was trying to prevent people on Medicaid from losing health coverage, Idaho dropped nearly 10,000 people from the safety-net program. Federal law generally banned states from dropping…

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

It was the first day of her family’s vacation in the San Juan Islands last June when Danielle Laskey, who was 26 weeks pregnant, thought she was leaking amniotic fluid. A registered nurse, Laskey called her OB-GYN back home in…