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Insurance, Coverage & Costs: The Future Of The ACA | Uninsured In Coal Country | High-Risk Pools


Insurance, Coverage & Costs

Thursday, November 17, 2016
Check Kaiser Health News online for the latest headlines

This email contains the latest from Kaiser Health News about insurance, coverage and health care costs.  To view all KHN resources on these topics, visit the Insurance or Health Costs news pages.

Despite Anger At Health Law’s Mandate, GOP Plans Could Also Have Penalties
President-elect Donald Trump has suggested that he would like to keep the health law’s ban on preexisting conditions. But that only works if insurers can be guaranteed a robust market, so Republicans must figure out a way to coax in healthy customers.

Republicans Likely To ‘Give Themselves Time’ To Set Health Law Replacement
KHN’s Julie Rovner joins a panel on ‘NewsHour’ to talk about how the new Trump administration and congressional Republicans might seek to repeal and replace the federal health law.

Concerned About Losing Your Marketplace Plan? ACA Repeal May Take Awhile
Republican efforts to get rid of the federal health law are expected to take some time to work through Congress and leaders have promised to give consumers time to adjust to those changes.

Repealing The Affordable Care Act Could Be More Complicated Than It Looks
Republicans will likely chip away at the ACA piecemeal and say they will try to provide a soft exit.

Uninsured In Coal Country: Desperate Americans Still Turn To Volunteer Clinics
Dire dental needs and other health problems keep Remote Area Medical’s pop-up free clinics busy in states like Virginia that haven’t expanded Medicaid. 

Healthy Customers, And Those With Major Medical Needs, May Want Bronze Plans
The bronze plans’ lower premiums — coupled with the health law’s out-of-pocket-spending protections — may make these policies an attractive option.

7 Tips To Help Avoid Costly Health Plan Enrollment Headaches
Despite fears of rising costs and fewer insurers on the health law’s marketplaces, consumers can find the best deals by carefully evaluating plans and checking out the fine print.

Sounds Like A Good Idea? High-Risk Pools
A KHN video looks at a Republican plan to establish a federal high-risk insurance pool.

Feds Find Doctor Listings Often Wrong In Medicare Advantage Directories
The federal government’s first in-depth review reveals errors such as wrong addresses and incorrect phone numbers riddle many directories used by Medicare Advantage beneficiaries. 

Are Blues’ Plans Benefiting Unfairly From Program To Offset Cost Of Sicker Patients?
Other insurers complain that Blue Cross Blue Shield plans have bloated overhead costs and reap too much from the Obamacare risk-adjustment fund, paid for by insurers. The companies deny it.

7 Insurers Alleged To Use Skimpy Drug Coverage To Discourage HIV Patients
The plans sought to discourage costly HIV patients by not including their drug needs in formularies or requiring high cost sharing, a Harvard Law School group says in a complaint filed with HHS.

Everything Californians Wanted To Know About Their Health Plan (But Were Afraid To Ask)
A new online database created by the Department of Managed Health Care can help consumers size up and compare insurance plans.

Health Law Targets Women’s Preventive Services, But It Offers Help To Men, Too
A number of preventive services used by both men and women are now available at no cost to consumers.

UnitedHealth And University Of California To Forge Unique Alliance
The nation’s largest insurer and the state’s university health system intend to offer a health plan option to self-funded employers in California and pursue research drawing upon a huge reservoir of patient data.

Would You Like Some Insurance With Your Insurance?
Gap insurance plans, used to cover out-of-pocket health expenses like high deductibles, are becoming increasingly popular among consumers and businesses.

Hitch Keeps Many High-Deductible Plans From Covering Chronic Care Up Front
IRS rules limit plans set up to link to health savings accounts from covering most care until the deductible is paid off, but proposed legislation would expand what’s allowed.

Seattle Dentists, Clinics And A Hospital Partner To Provide Specialty Care For Teeth
A pilot project involving Swedish Medical Center and the Neighborcare Health network of community clinics offers care for uninsured adults or those on Medicaid.

Studies Link Cancer Patient’s Survival Time To Insurance Status
Research on patients with testicular cancer and others fighting a brain malignancy finds that people who are privately insured are more likely to be diagnosed earlier and survive longer.

Studies: Employer Costs Slow As Consumers Use Less Care, Deductibles Soar
Cost pressures may induce patients to forgo needed care, some worry.

Insurers May Insist On Counseling Before Genetic Tests For Breast Cancer
Doctors are concerned that requiring referrals to genetic counselors can deter women from going forward with testing for genetic mutations that cause breast cancer.

Getting Doctor Lists Right
Under a new state law, California consumers could get money back if they were charged out-of-network prices after going to a medical provider who was listed in their health plan’s network.

Taxpayers Foot 70 Percent Of California’s Health Care Tab, Study Finds
The public spending on health care outpaces the nation.

Patients, Fearing Pricey Follow-Ups, May Shy Away From Some Colon Cancer Tests
Most screening tests for colon cancer are covered by insurance but if they come back positive, they may require a diagnostic colonoscopy and that may not be covered completely by insurance.

Insurance Doesn’t Ensure Children Get Needed Visual Exams, Study Says
Researchers estimate thousands of children suffer two debilitating eye conditions because they don’t get proper exams while young.

More Small, Midsized Firms Choose To Pay Workers’ Medical Costs Directly
Many expected that the federal health law would push these employers in this direction. An analysis by the Employee Benefit Research Institute finds evidence that these predictions are coming to fruition.

Should Big Insurance Become Like Walmart To Lower Health Costs?
Evidence shows dominant insurers hold down hospital prices. Big insurers seeking to get bigger want to take that idea to the extreme.

Insurers May Share Blame For Some Generics’ Price Hikes
News reports have led many consumers to blame drugmakers for the rapidly rising costs of some commonly used generic drugs. But changes made by insurers often play a major role, too.

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2016 Kaiser Health News. All rights reserved.

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