Kaiser Health News
Deny and Delay? California Seeks Penalties for Insurers That Repeatedly Get It Wrong
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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Kaiser Health News
An Ice Rink To Fight Opioid Crisis: Drug-Free Fun vs. Misuse of Settlement Cash
SUMMARY: Carter County, Kentucky, has controversially spent $15,000 of its opioid settlement funds on an ice rink, raising concerns about its relevance to the ongoing opioid crisis. Advocates argue that resources could be better allocated to overdose prevention, such as Narcan kits or local substance abuse programs. Brittany Herrington, a local in recovery, criticized the decision as neglecting community needs. While officials claim the rink fosters drug-free youth activities, critics note it lacks direct ties to combating addiction. Local leaders are calling for stricter oversight on how settlement funds are used, emphasizing the need for targeted support in addressing substance use disorders.
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Kaiser Health News
Republicans Are Eyeing Cuts to Medicaid. What’s Medicaid, Again?
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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Kaiser Health News
Iowa Medicaid Sends $4M Bills to Two Families Grieving Deaths of Loved Ones With Disabilities
SUMMARY: Iowa’s collection agents are pursuing millions in Medicaid reimbursements from the estates of deceased individuals with disabilities, including Kristin Higgins and Eric Tomlyn, who spent decades at the Glenwood Resource Center. Their families received bills exceeding $4 million, despite both having minimal income and assets. Critics argue that Medicaid estate recovery disproportionately affects low-income families, while wealthier families often evade these debts. The practice has drawn national scrutiny, with calls for reforms to limit aggressive collection efforts. Some states, like Massachusetts, have already curbed similar programs, but Iowa’s aggressive approach continues, generating significant revenue for the Medicaid program.
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