Category Archives: Insurance

Webcast to explain why free
preventive care under the ACA is at risk

A. Mark Fendrick, M.D.

One of the most important requirements of the Affordable Care Act is that all Americans get free preventive services. This provision is significant in a health care system that regularly bills patients exorbitant amounts for many routine services designed to identify and prevent potentially significant health problem. 

The provision is in jeopardy, however, according to a decision last month from Judge Reed O’Connor in the U.S. District Court for the Northern District of Texas in Fort Worth. In the case, Braidwood Management Inc. v Xavier Becerra, O’Connor ruled on March 30 that no-cost preventive health care is unconstitutional. 

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Story angles to consider when covering Medicaid and CHIP unenrollment

Source: Unwinding the Medicaid Continuous Enrollment Provision: Projected Enrollment Effects and Policy Approaches, published by the federal Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, Office of Health Policy, Aug. 19, 2022.

Health care journalists have multiple story angles to pursue as states disenroll adults and children from Medicaid and the Children’s Health Insurance Program (CHIP). 

In a new tip sheet, we report that on April 1, states began unenrolling members in both programs because the coronavirus public health emergency will end along with the continuous enrollment provisions that Congress passed in the Families First Coronavirus Response Act of 2020. 

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Top 2023 policy stories: end of public health emergency and telehealth

“Public health legislation in the new Congress” session panelists Timothy McBride, professor of public health at Washington University in St. Louis.; Cara Tenenbaum, principal at Strathmore Health Strategy; Leann Chilton, vice president of government relations at BJC HealthCare (Photo by Zachary Linhares)

For journalists seeking important health care policy stories in 2023, look to the impact of the end of the public health emergency on Medicaid enrollment and how it may change the number of people who are uninsured, experts said on March 11 during “Public health legislation in the new Congress” session at Health Journalism 2023 in St. Louis. Federal action on telehealth and its impact on health equity and rural health care will also be key policy topics to follow during the year, they said.

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Minnesota journalist uncovers lawsuits Mayo Clinic filed against patients

Molly Work

In July, US News and World Report ranked the Mayo Clinic in Rochester, Minn., as the nation’s best hospital for the seventh consecutive year.

Looking more closely at how US News assessed hospitals, reporters at Rochester’s daily newspaper, the Post Bulletin, noticed that on the issue of health equity, the Mayo Clinic was ranked significantly lower than other hospitals. The editors at US News defined charity care as, “How well hospital spending on free and discounted care for uninsured patients aligns with the proportion of uninsured in the surrounding community.”

Since September, Molly Castle Work, an award-winning investigative journalist (@mollycastlework), for the Post Bulletin, has published at least six articles about the Mayo Clinic and charity care. Check out her Shared Wisdom to learn more about her strategy for pursuing this story.

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Reporters shed light on unsubstantiated drug price increases 

The table shows the 10 prescription medications that had price increases in 2021 that were unsupported by new clinical evidence. Reprinted with permission. Source: Rind DM, Agboola F, Campbell J, Nikitin D, et al. Unsupported Price Increase Report: Unsupported Price Increases Occurring in 2021. December 6, 2022. ICER.

Last year, the makers of seven widely used prescription drugs raised prices substantially without any new clinical evidence to justify the increases, Ed Silverman reported at STAT News last week. 

Silverman based his reporting on an analysis from the independent nonprofit Institute for Clinical and Economic Review (ICER) that analyzes evidence on the effectiveness and value of drugs and other medical services. ICER released that report, “Unsupported Price Increases (UPI) of prescription drugs in the United States,” on Tuesday, Dec. 6.  

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