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Health Insurers Limit Coverage of Prosthetic Limbs, Questioning Their Medical Necessity

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kffhealthnews.org – Michelle Andrews – 2025-01-06 04:00:00

SUMMARY: In 2023, Michael Adams faced insurance denial for a crucial prosthetic leg replacement. After losing his leg to cancer 40 years ago, he selected a health plan that covered advanced prosthetics, but his insurer deemed the replacement unnecessary, despite his doctor’s long-standing recommendation. This disparity in coverage, particularly between joint replacements and prosthetics, highlights ongoing discrimination in the amputee community. An estimated 2.3 million Americans live with limb loss, and many encounter barriers to obtaining necessary prosthetics. Leah Kaplan also struggled with insurance denial for a myoelectric prosthetic hand, emphasizing the financial and emotional toll of inadequate insurance coverage.

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Kaiser Health News

Medicaid Expansion Debate Will Affect Other Health Policy Issues Before Montana Legislature

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kffhealthnews.org – Mike Dennison and Sue O’Connell – 2025-01-08 04:00:00

SUMMARY: Montana’s Medicaid expansion program, which provides healthcare for over 75,000 low-income residents at a cost of about $1 billion annually, faces a pivotal debate in the 2025 legislature due to a 2019 bill’s end date of June 30, 2025. Legislative leaders expect discussions on renewal will intertwine with other health policies, like behavioral health funding and hospital regulations. Governor Gianforte supports continued funding but insists on work requirements. While Republicans express skepticism about Medicaid’s costs, Democrats advocate for its permanence. Additionally, abortion regulations are anticipated despite a recent constitutional vote affirming abortion rights in Montana.

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Kaiser Health News

Health Care Is Newsom’s Biggest Unfinished Project. Trump Complicates That Task.

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kffhealthnews.org – Angela Hart and Christine Mai-Duc – 2025-01-07 04:00:00

SUMMARY: California Governor Gavin Newsom has made significant strides in health care accessibility, directing billions to safety net services and extending Medi-Cal benefits to over a million undocumented residents. However, rising costs, worsening homelessness, and ongoing health care access challenges remain. With the potential shift in federal policy under Donald Trump’s return to the presidency, California faces funding cuts, risking reductions in coverage and benefits. Notable initiatives like the expansion of Medi-Cal and affordable generic drugs have stalled, while homelessness continues to rise despite heavy investments. Newsom remains committed to reform but faces significant obstacles in his final two years.

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Kaiser Health News

Syringe Exchange Fears Hobble Fight Against West Virginia HIV Outbreak

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kffhealthnews.org – Taylor Sisk – 2025-01-03 04:00:00

SUMMARY: Despite federal recommendations, West Virginia grapples with a persistent HIV outbreak linked to opioid and methamphetamine use. Since the CDC’s 2021 visit highlighted the crisis, health officials and advocates have fought for syringe service programs to curb the epidemic. However, restrictive local policies hinder these efforts, and a previous program was shut down in 2018 due to political pressure. While alternative programs exist, they struggle with limited resources and support. Experts call for a coordinated statewide testing strategy and greater access to harm reduction services, urging policymakers to prioritize public health over political fears regarding drug use.

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