Kaiser Health News
A Toddler Got a Nasal Swab Test but Left Before Seeing a Doctor. The Bill was $445.
SUMMARY: In December, 3-year-old Ryan Wettstein Nauman from Peoria, Illinois, experienced inconsolable crying, prompting her mother, Maggi, to take her to the emergency room. After waiting, Ryan stopped crying and they decided to leave without seeing a doctor. Months later, they received a $445 bill for a covid and flu test conducted during their brief ER visit, despite Ryan only being triaged. After insurance adjustments, they owed $298.15. The high hospital markup and insurance rules post-public health emergency raised concerns for Wettstein, leading her to reconsider future ER visits in favor of urgent care options for non-life-threatening issues.
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Kaiser Health News
Medicaid Expansion Debate Will Affect Other Health Policy Issues Before Montana Legislature
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.
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
Health Insurers Limit Coverage of Prosthetic Limbs, Questioning Their Medical Necessity
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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