Kaiser Health News
KFF Health News’ ‘What the Health?’: Trump Puts Obamacare Repeal Back on Agenda
Fri, 01 Dec 2023 00:20:00 +0000
The Host
Julie Rovner
KFF Health News
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 Z,” now in its third edition.
Former president and current 2024 Republican front-runner Donald Trump is aiming to put a repeal of the Affordable Care Act back on the political agenda, much to the delight of Democrats, who point to the health law’s growing popularity.
Meanwhile, in Texas, the all-Republican state Supreme Court this week took up a lawsuit filed by more than two dozen women who said their lives were endangered when they experienced pregnancy complications due to the vague wording of the state’s near-total abortion ban.
This week’s panelists are Julie Rovner of KFF Health News, Joanne Kenen of Johns Hopkins University and Politico Magazine, Victoria Knight of Axios, and Sarah Karlin-Smith of the Pink Sheet.
Panelists
Joanne Kenen
Johns Hopkins Bloomberg School of Public Health and Politico
Victoria Knight
Axios
Sarah Karlin-Smith
Pink Sheet
Among the takeaways from this week’s episode:
- The FDA recently approved another promising weight loss drug, offering another option to meet the huge demand for such drugs that promise notable health benefits. But Medicare and private insurers remain wary of paying the tab for these very expensive drugs.
- Speaking of expensive drugs, the courts are weighing in on the use of so-called copay accumulators offered by drug companies and others to reduce the cost of pricey pharmaceuticals for patients. The latest ruling called the federal government’s rules on the subject inconsistent and tied the use of copay accumulators to the availability of cheaper, generic alternatives.
- Congress will revisit government spending in January, but that isn’t soon enough to address the end-of-the-year policy changes for some health programs, such as pending cuts to Medicare payments for doctors.
- “This Week in Medical Misinformation” highlights a guide by the staff of Stat to help lay people decipher whether clinical study results truly represent a “breakthrough” or not.
Also this week, Rovner interviews KFF Health News’ Rachana Pradhan, who reported and wrote the latest “Bill of the Month” feature, about a woman who visited a hospital lab for basic prenatal tests and ended up owing almost $2,400. If you have an outrageous or baffling medical bill you’d like to share with us, you can do that here.
Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:
Julie Rovner: KFF Health News’ “Medicaid ‘Unwinding’ Makes Other Public Assistance Harder to Get,” by Katheryn Houghton, Rachana Pradhan, and Samantha Liss.
Joanne Kenen: KFF Health News’ “She Once Advised the President on Aging Issues. Now, She’s Battling Serious Disability and Depression,” by Judith Graham.
Victoria Knight: Business Insider’s “Washington’s Secret Weapon Is a Beloved Gen Z Energy Drink With More Caffeine Than God,” by Lauren Vespoli.
Sarah Karlin-Smith: ProPublica’s “Insurance Executives Refused to Pay for the Cancer Treatment That Could Have Saved Him. This Is How They Did It,” by Maya Miller and Robin Fields.
Also mentioned in this week’s episode:
- KFF Health News’ “Progressive and Anti-Abortion? New Group Plays Fast and Loose to Make Points,” by Darius Tahir.
- ProPublica’s “Some Republicans Were Willing to Compromise on Abortion Ban Exceptions. Activists Made Sure They Didn’t,” by Kavitha Surana.
Credits
Zach Dyer
Audio producer
Emmarie Huetteman
Editor
To hear all our podcasts, click here.
And subscribe to KFF Health News’ “What the Health?” on Spotify, Apple Podcasts, Pocket Casts, or wherever you listen to podcasts.
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Title: KFF Health News’ ‘What the Health?’: Trump Puts Obamacare Repeal Back on Agenda
Sourced From: kffhealthnews.org/news/podcast/what-the-health-324-trump-agenda-repeal-obamacare-agenda-november-30-2023/
Published Date: Fri, 01 Dec 2023 00:20:00 +0000
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Kaiser Health News
In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M
SUMMARY: Independent Health Association of Buffalo and Betsy Gaffney, CEO of medical analytics firm DxID, have agreed to a settlement of up to $100 million to resolve Justice Department allegations of fraudulent Medicare billing for exaggerated or non-existent health conditions. Independent Health will pay up to $98 million, while Gaffney will contribute $2 million. Neither party admitted wrongdoing. The case was triggered by whistleblower Teresa Ross, highlighting issues of “upcoding” in Medicare Advantage plans. Ross, having faced repercussions for her allegations, will receive at least $8.2 million from the settlement. This case underscores the challenges of regulating billing practices in the Medicare system.
The post In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M appeared first on kffhealthnews.org
Kaiser Health News
Employers Press Congress To Cement Health Price Transparency Before Trump’s Return
SUMMARY: Despite regulations requiring hospitals and insurers to disclose negotiated prices for healthcare services, the impact on consumer costs remains unclear nearly four years later. While the Trump administration’s initial rules and Biden’s enhancements aimed to streamline this data, compliance is inconsistent; a 2022 audit found only 63 out of 100 hospitals met requirements. Some lawmakers proposed legislation to protect these regulations amid uncertainty about Trump’s potential return to office, but efforts fell short. Experts note the complexity of the data often leaves consumers struggling to understand their actual costs, emphasizing the need for improved transparency and enforcement to facilitate informed healthcare choices.
The post Employers Press Congress To Cement Health Price Transparency Before Trump’s Return appeared first on kffhealthnews.org
SUMMARY: Tom Contos, a 45-year-old runner, sought a colonoscopy due to ongoing rectal bleeding. His insurance covered part of the procedure, but he was shocked by the final bill of $19,206, which included charges for two colonoscopies. Despite an initial estimate of $7,203, the charges were much higher due to multiple procedures and biopsies. Contos appealed the charges, but Northwestern Medicine maintained that the billing was correct. Health experts suggest patients consider alternatives like ambulatory surgery centers for lower costs. Transparency and clear pricing are key to avoiding unexpected medical expenses.
The post He Went in for a Colonoscopy. The Hospital Charged $19,000 for Two. appeared first on kffhealthnews.org
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