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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

Texas Measles Outbreak Nears 100 Cases, Raising Concerns About Undetected Spread

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kffhealthnews.org – Amy Maxmen – 2025-02-21 10:15:00

SUMMARY: A measles outbreak in West Texas has led to private school closures, overwhelming local health departments. Since the outbreak began three weeks ago, 90 cases have been confirmed, mostly in children under 18, with 16 hospitalizations. Health officials fear the outbreak will worsen, and some parents may be avoiding testing their children. The outbreak has been exacerbated by low vaccination rates, particularly in communities like Gaines, which has one of the lowest vaccination rates in Texas. Local officials are working to contain the virus through pop-up clinics, mobile testing, and educating schools, but the situation remains challenging.

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GOP Takes Aim at Medicaid, Putting Enrollees and Providers at Risk

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kffhealthnews.org – Phil Galewitz, KFF Health News – 2025-02-21 04:00:00

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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An Ice Rink To Fight Opioid Crisis: Drug-Free Fun vs. Misuse of Settlement Cash

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kffhealthnews.org – Aneri Pattani – 2025-02-20 04:00:00

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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