Category Archives: Health care reform

Journalists expose significant problems with Medicare Advantage plans

Majority report from US Senate Finance Committee finds seniors subject to marketing scams from health insurers.

Seniors signing up for Medicare Advantage (MA) during open enrollment (which ends Dec. 7) have more reasons to worry now that reporters at Kaiser Health News, MedPage Today and elsewhere have continued to uncover significant problems with these private managed care plans. 

During open enrollment, reporters have a responsibility to explain the problems seniors may face with MA plans and to warn them about deceptive marketing practices.

And health care journalists should ask officials at the federal Centers for Medicare and Medicaid Services (CMS) why it sets higher rates for health insurance brokers selling MA plans than the rates it sets for brokers to register seniors in Medicare Supplement (also called Medigap) plans that might be more appropriate for their needs.  Continue reading

Election coverage lessons on Medicaid expansion, abortion, medical debt and dental insurance

South Dakota voters approve amendment to state constitution to expand access to Medicaid (Source: Status of State Medicaid Expansion Decisions: Interactive Map, Kaiser Family Foundation, accessed Nov. 9, 2022.)

Even while votes are still being counted, there are important lessons to be learned from the midterm elections on Tuesday. 

One of the big lessons is that when voters are asked whether to expand Medicaid, they mostly vote in favor, as happened when South Dakota approved an amendment to the state constitution this week, requiring the state to expand access to Medicaid benefits to low-income residents. 

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How seniors can avoid Medicare Advantage marketing scams, care denials and medical underwriting 

Caption: The Medicare & You 2023 handbook explains the rules for traditional Medicare, Medicare Advantage and Medigap plans.

Just after Medicare open enrollment began on Oct. 15, federal health officials cracked down on misleading and incorrect ads from health insurers promoting the low premiums and additional benefits available in Medicare Advantage (MA) plans.

On Friday, Cheryl Clark reported for MedPage Today that the federal Centers for Medicare and Medicaid Services (CMS) said it reviewed thousands of complaints about confusing, misleading, or inaccurate ads for MA plans and it used secret shoppers to document deceptive telephone pitches from agents and brokers selling MA plans to consumers. In a letter to all insurers offering MA and prescription drug plans, CMS said some insurance agents were unduly pressuring beneficiaries and failing to provide accurate or complete information to help seniors make informed enrollment decisions. 

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When reporting on ACA open enrollment, explain the ‘family-glitch’ fix

This map online is interactive, meaning journalists can click on a state to see the number of residents who are in the family glitch. Source: Kaiser Family Foundation report, “The ACA Family Glitch and Affordability of Employer Coverage,” published April 7, 2022.

On Tuesday, the Internal Revenue Service issued a rule designed to eliminate the so-called “family glitch” in the Affordable Care Act (ACA) that made employer-based coverage unaffordable for many families.

When reporting on this rule change, the Associated Press got it right, summed it up like this, “Families who get expensive health insurance through employers could see a price break if they sign up instead for coverage through the Affordable Care Act marketplace this fall.”

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Why hospital charity care requires more intensive coverage

Photo via Canva

Multiple reports published this week show why health care journalists need to spend more time covering the charity care that nonprofit hospitals are required to deliver to patients but mostly fail to provide.

Each report cited below outlines how to cover this important story on hospital care and how the nation’s health care system so often fails to deliver equitable care to low-income Americans.

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