Mary Chris Jaklevic, AHCJ’s health beat leader for patient safety, contributed to this article.
In the past year, journalists and health researchers have uncovered troubling facts about how health insurers fail members by delaying or denying care through prior authorization. Also called prior approval, this process is a cost-cutting tool that health insurers use to require patients or doctors to get an okay before agreeing to pay for tests, procedures and prescription drugs, as Lauren Sausser reported for KFF Health News in August.
Junk insurance plans that don’t meet the standards of the Affordable Care Act are one of the biggest holes in the patchwork that is the U.S. health insurance system. These plans are typically short-term policies that often discriminate against people with pre-existing conditions and aren’t required to provide coverage for basic services like maternity care, prescription medications and more, according to Aimed Alliance.
KFF research shows the estimated value of tax exemptions for nonprofit hospitals in 2020 was $28 billion, exceeding estimated charity care costs of about $16 billion among those hospitals. Source: Chart by KFF, accessed June 8, 2023. Reprinted with permission
So far this year, hardly a week goes by without an article or report on egregious actions by nonprofit hospitals. While the actions aren’t new, several factors have combined in 2023 to raise the level of scrutiny.
Even before the Affordable Care Act became fully effective in 2014, more than 94% of Americans buying contraceptives were paying some amount out-of-pocket. That dropped to 10% by 2018, according to a May 2023 KFF report. Accessed July 5, 2023. Image courtesy KFF, reprinted with permission
Investigative journalist Anna Wolfe. Photo courtesy of Anna Wolfe
Investigative journalist Anna Wolfe has a secret.
During a multi-year investigation into a sprawling scandal over misspent welfare funds in Mississippi, Wolfe received dozens of text messages that helped to blow the lid off the case. Since getting those messages last year, the award-winning reporter has protected her source’s anonymity. But in an interview with AHCJ, she promised to reveal the name someday — when the time is right.
On May 8, Wolfe won a Pulitzer Prize in the local news category for Mississippi Today, a nonprofit news organization founded in 2016, for her coverage of what’s called the biggest public corruption scandal in the state’s history.