Author Archives: Joanne Kenen

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Shedding light on upcoding in the ER

Photo: Micheal J via Flickr

The Houston Chronicle’s Jenny Deam delved into emergency room billing – hospital facility fees as well as “upcoding,” which means categorizing relatively minor conditions as serious or even life-threatening ailments and charging a lot for them.

It raises costs to both the patient and the insurer. Continue reading

After appeals court arguments, ACA back in limbo

The oral arguments in the Texas v. United States lawsuit aiming to overturn the Affordable Care Act did not go well for backers of the health law on Tuesday. Two of the three judges on the Fifth Circuit Court of Appeals seemed ready to scrap at least pivotal chunks of the ACA.  (Here’s a wrap from AP.)

But what comes next – or when it happens – is still a guessing game.

Continue reading

Oral arguments and legal drama in the Texas v. United States ACA case

On Tuesday, July 9, the Fifth Circuit Court of Appeals will hear oral arguments in the appeal of Texas v. United States.

The conventional wisdom, even among conservative legal scholars, is that the case was based on such a contorted legal theory that it should not be taken all that seriously.

Then, in December, U.S. District Court Judge Reed O’Connor agreed with Texas and 17 other conservative states and declared the whole Affordable Care Act unconstitutional. Continue reading

Case over risk corridor payments to go before Supreme Court

Photo by dbking via Flickr

We wrote earlier this spring about a batch of ACA litigation still slogging its way through the courts, including one that the Supreme Court has just agreed to take. This is a challenge from health insurers who say the federal government owes them a great big bushel of money.

The case, which is consolidating three lawsuits known as Moda Health Plan v. United States, Maine Community Health Options v. United States, and Land of Lincoln Mutual Health Insurance v. United States, means that the government could have to pay out billions of dollars under the Affordable Care Act – while that very same federal government is still trying to dismantle the ACA in the Texas vs. Azar lawsuit that goes before an appeals court in July. Continue reading

Pain, profit and accountability in Medicaid managed care

Tom Fox/The Dallas Morning NewsA mobility and orientation specialist slowly moves an amber rope light above D’ashon Morris’ eyes during a visual stimulation therapy appointment at his Mesquite, Texas home on March 6, 2018.

A powerhouse series on patient harm under Texas’s Medicaid Managed Care program won the Shorenstein Center’s Goldsmith Prize for Investigative Reporting and was recognized with an AHCJ award.  We’ve posted a “How I Did It” piece by the Dallas Morning News reporters, David McSwane and Andrew Chavez.

Their work showed the lack of oversight endangering about 4 million Texans, including about 720,000 who are medically fragile – both adults and children, including some in foster care. Continue reading

In midst of national ‘Medicare for All’ debate, one state takes own action

Photo: Stuart Moulder via Flickr

Washington has become the first state to move ahead with a version of a public option – an element of the markets that was part of the original 2009 Affordable Care Act legislation but didn’t survive the U.S. Senate.

The idea was to have one government-run health plan within the exchange to enhance competition with private insurers and keep down costs. Continue reading