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Election Outcome Could Bring Big Changes to Medicare

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kffhealthnews.org – Stephanie Armour – 2024-11-04 03:00:00

SUMMARY: During the campaign, both Donald Trump and Kamala Harris are positioning themselves as defenders of Medicare, each blaming the other for potential cuts to the program. The election could significantly impact Medicare’s future, especially with more beneficiaries opting for Medicare Advantage plans run by private insurers, a trend that could escalate under a Trump administration. Critics warn that increased privatization would limit care options and raise costs, while supporters argue these plans provide better benefits. Polls indicate that a candidate’s stance on Medicare heavily influences voter decisions, highlighting the program’s importance in the upcoming election.

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Who Gets Obesity Drugs Covered by Insurance? In North Carolina, It Helps If You’re on Medicaid

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kffhealthnews.org – Melba Newsome – 2024-12-02 04:00:00

SUMMARY: Anita Blanchard, a University of North Carolina-Charlotte professor, struggled with weight loss until she found success with Ozempic, a medication initially for Type 2 diabetes, leading her to lose 45 pounds and improve her mental health. However, North Carolina’s state employee health plan recently eliminated coverage for weight loss medications, citing high costs that could exceed $1 billion over six years. In a contrasting move, the state’s Medicaid program began covering these drugs for low-income residents. The Biden administration also proposed similar coverage nationally. Experts advocate for treating obesity as a chronic disease rather than a personal failing.

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A Toddler Got a Nasal Swab Test but Left Before Seeing a Doctor. The Bill was $445.

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kffhealthnews.org – Bram Sable-Smith – 2024-11-27 04:00:00

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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Florida’s Deloitte-Run Computer System Cut Off New Moms Entitled to Medicaid

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kffhealthnews.org – Daniel Chang and Samantha Liss – 2024-11-26 04:00:00

SUMMARY: In May, Mandi Rokx, a Florida mother, received a notice that she and her baby would be cut from Medicaid despite being eligible. Florida’s 2021 law promised 12 months of continuous coverage post-birth, but a computer glitch in the state’s eligibility system, run by Deloitte, led to wrongful cuts. This error, along with others during Florida’s Medicaid review process, has affected many new mothers. A class-action lawsuit highlights how these errors led to loss of coverage for eligible individuals. While Rokx regained coverage after legal intervention, the broader issues persist, impacting thousands across multiple states.

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