Obamacare health plans have been criticized for severely restricting the doctors and hospitals that patients can see. But sometimes even those limited provider lists are riddled with errors, causing additional headaches for patients who had purchased a plan hoping to keep their physician only to later discover that doctor isn’t fully covered by insurance.
Marketplace insurers are fighting lawsuits from consumers in four different states who say they were misled about which health providers were covered under their plan. It wasn’t until after purchasing the plan, these patients allege, that they learned their doctor or hospital was outside its network and therefore covered only partially or not at all.
As House Democrats sit down to draft their vision of governance in the coming weeks, lawmakers find themselves badly divided.
Centrists from swing districts, with the tacit support of Speaker Nancy Pelosi, favor incremental moves to shore up the Affordable Care Act and to lower the out-of-pocket costs of prescription drugs and medical care. They are pushing a variety of measures, such as shutting down cheap, short-term insurance plans that do not cover pre-existing medical conditions and allowing people to buy into Medicare at age 50 or 55.
But they are butting up against an aggressive and expanding group of more than 100 outspoken Democrats — as well as at least four of the party’s presidential candidates — who want to upend the whole system with a single government insurance plan for all Americans — the old concept of single payer, now called Medicare for all.
Federal regulators Friday approved Ohio’s request to require thousands of Medicaid recipients to work, attend classes or train for a job to qualify for benefits.
The federal Centers for Medicare and Medicaid Services notified state officials that they could impose work requirements on able-bodied adults up to age 50 enrolled in the tax-funded health insurance program.
Ohio is the 9th state to get permission to mandate work for certain Medicaid beneficiaries. So far, only Arkansas, Indiana and New Hampshire have implemented the requirement.
Legal challenges aren’t slowing down the Trump administration’s push to reframe Medicaid as something closer to a welfare program.
Driving the news: The Centers for Medicare & Medicaid Services on Friday approved Ohio’s proposal to add work requirements to its Medicaid program.
- Just a day earlier, Justice Department lawyers were back before the same federal judge who ruled against work requirements last year, urging him to let the policy move forward now.
Republican-led states are stepping up their efforts with the Trump administration to pursue work requirements and other changes to Medicaid, in the face of legal challenges and Democratic opposition.
Tennessee Republicans want permission to revamp Medicaid in exchange for a fixed amount from the federal government. Utah is testing whether it can get approval for a partial Medicaid expansion with capped payments from the federal government. And Kentucky lawmakers have weighed drug-testing recipients with criminal or substance-abuse histories, among other steps.
The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief.
Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, had never been tested for or diagnosed until she turned up in the emergency room days before her death.
Eliminating profit from an entire sector of the national economy would be unprecedented. But the example of New York, on a smaller scale, shows why it is a recipe for dysfunction.
The Empire State’s hospital industry has been 100% nonprofit or government-owned for more than a decade. It’s a byproduct of longstanding, unusually restrictive ownership laws that squeeze for-profit general hospitals. The last one in the state closed its doors in 2008.
A report last year from the Albany-based Empire Center shows the unhappy results. The state health-care industry’s financial condition is chronically weak, with the second-worst operating margins and highest debt loads in the country. And there’s no evidence that expunging profit has reduced costs. New York’s per capita hospital spending is 18% higher than the national average.