Author Archives: Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Experts have advice for the last-minute Medicare Advantage shoppers among your audience

A screenshot from a television ad on Friday for a Medicare Advantage plan from UnitedHealthcare.

A screenshot from a television ad on Friday for a Medicare Advantage plan from UnitedHealthcare.

Watching the TV ads during the evening news, you would think Medicare Advantage plans were the greatest health insurance bargain ever invented. Consumers should not be fooled, however.

It’s true that the federal Centers for Medicare and Medicaid Services made it possible for Medicare Advantage (MA) health plans to offer more benefits to seniors enrolled in Medicare. Some of these plans offer coverage for vision, hearing, and gym memberships) while not charging a monthly premium, and some MA plans will even pay for seniors’ Medicare Part B premium, said John Barkett, a senior director of policy affairs at the health care consulting firm Willis Towers Watson. Continue reading

NIH head: Journalists have important role in explaining the science behind vaccine development

Francis S. Collins

Francis S. Collins

As coronavirus infections rise nationwide, health care journalists have an important role in explaining the science behind the development, safety and effectiveness of COVID-19 vaccines, said Francis S. Collins, M.D., Ph.D., the director of the National Institutes of Health.

As the Nov. 18 keynote speaker at AHCJ’s Journalism Summit on Infectious Disease, Collins gave a stark warning for journalists and all Americans about the need to recognize the value of the vaccines as they are rolled out in the coming months. Continue reading

During open enrollment, consumers will need help recognizing plans that comply with the Affordable Care Act

questions1Journalists covering open enrollment for the Affordable Care Act this year will need to separate fact from fiction about the law and about coverage for pre-existing conditions.

As we saw on Tuesday, the U.S. Supreme Court heard oral arguments on whether it should strike down the individual mandate and the entire ACA in a case we covered in a blog post on Monday. One of the big issues in any debate involving the ACA is coverage for Americans who have pre-existing conditions. During the coronavirus pandemic, this issue is even more important than it was in previous years because more than 10 million cases have been reported, according to The New York Times. Many of those Americans now have a pre-existing condition they did not have last year. Continue reading

Supreme Court case on Affordable Care Act could have far-reaching effects on Medicaid expansion, pre-existing condition protections

Photo by dbking via Flickr

On Tuesday, the U.S. Supreme Court will hear oral arguments on whether it should strike down the individual mandate and the entire Affordable Care Act.

As always, SCOTUSblog has all the details on the case, California v. Texas and Texas v. California (both of which have been consolidated for oral arguments on whether the ACA’s requirement that Americans get health insurance is constitutional and, if not, whether the rest of the ACA can survive). Continue reading

Provider groups closely monitor Supreme Court case on pharmacy benefit managers

The U.S. Supreme Court this month heard oral arguments in the case of Rutledge v. Pharmaceutical Care Management Association. At issue is the right of states to regulate pharmacy benefit management (PBMs) companies, which employers and health plans hire as middlemen to manage their prescription benefit programs for workers and other plan members.

During oral arguments on Oct. 6, several justices asked about the burden that health plans encounter when PBM regulations differ from one state to another, as Rachel Cohrs reported for Modern Healthcare. Continue reading

What Missouri, Oklahoma teach us about state efforts to expand Medicaid eligibility

Projected costs

Source: Analysis of the Fiscal Impact of Medicaid Expansion in Missouri, Center for Health Economics and Policy, Institute for Public Health, Washington University in St. Louis, 2019. Reprinted with permission.

Missouri voters in August approved a ballot measure that would expand Medicaid eligibility to include healthy adults, beginning July 1, 2021.

According to reporting at NPR by Alex Smith, 53.25% of 1.2 million voters approved the measure, meaning Missouri joins 36 other states and the District of Columbia in expanding Medicaid under the Affordable Care Act. The approval came despite strong opposition from Republicans and rural voters, Smith wrote. Continue reading