SUMMARY: Republicans are again targeting Medicaid, proposing significant funding cuts to finance President Trump’s agenda on tax cuts and border security. Approximately 79 million people rely on Medicaid and the Children’s Health Insurance Program (CHIP), vital for numerous hospitals and states. Amid Democratic resistance, potential cuts could include reducing federal matching funds and imposing work requirements, which critics argue adds unnecessary barriers. Historically controversial, these efforts reflect deep partisan divides over Medicaid’s role as a safety net versus a welfare program. Many Americans favor Medicaid, making proposed cuts politically sensitive. The outcome remains uncertain as GOP leaders face internal challenges.

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SUMMARY: During his confirmation hearing for Secretary of Health and Human Services, Robert F. Kennedy Jr. made inaccurate statements about Medicaid, such as claiming it is fully federally funded and that many enrollees face high out-of-pocket costs. Medicaid, a $880 billion program, provides health coverage to over 79 million low-income and disabled Americans. It differs from Medicare, which serves older adults. Eligibility depends on income, and states have flexibility in program design. Funding is shared between federal and state governments. Medicaid faces potential cuts, but its popularity (77% favorability) complicates efforts for significant changes.

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SUMMARY: Colleen Henderson faced a harrowing journey when her daughter was diagnosed with a grapefruit-sized tumor after initial misdiagnoses. The treatment cost exceeded $1 million, leading Henderson to battle UnitedHealthcare for coverage, ultimately resulting in bankruptcy. A California legislative proposal, SB 363, aims to penalize insurers who frequently deny claims and mandate transparency in denial rates. With an alarming 72% of appeals reversed, the bill could impact around 12.8 million Californians on private insurance. Consumer advocates stress the need for reforms to hold insurers accountable for denial practices, especially in mental health care, amid rising health care costs and insurance denials.

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The post Deny and Delay? California Seeks Penalties for Insurers That Repeatedly Get It Wrong appeared first on kffhealthnews.org