Category Archives: Insurance

Fellow looks at how Medicaid work requirements have been implemented in Arkansas

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.

Benjamin Hardy, a reporter with the Arkansas Nonprofit  News Network and a 2018 AHCJ Health Care Performance Reporting Fellow,  has just written a How I Did It essay on his coverage of Medicaid work requirements in Arkansas.

While seven states have received CMS approval of work requirements, Arkansas is the first to put them in effect.  The rest are either being challenged in court, or in the implementation phase – or in question as a Democratic governor succeeds a Republican one. Several more states – eight, by my latest count – have requests pending before CMS and that number could grow. Continue reading

As name implies, short-term health plans may not be a good deal for some consumers

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.

For an article on short-term health plans, journalist Nancy Metcalf found an ideal source: Stewart Lamotte, a 64-year-old retired restaurateur from Lawrenceville, Ga.

In a story that Consumer Reports published in December 2017, “Is Short-Term Health Insurance a Good Deal?”, Metcalf explained that when LaMotte shopped for health insurance, he didn’t qualify for a tax credit under the Affordable Care Act. Also, he balked at the $1,000 monthly premium and a deductible of $6,500 that was required for an ACA-compliant health insurance policy. Continue reading

Given that ‘step therapy’ is also called ‘fail first,’ there are many angles to pursue

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.

Photo: ZaldyImg via Flickr

For journalists covering the Trump administration’s plan to expand step therapy to Medicare Advantage, there are important angles to cover now.

Under the rule issued by the federal Centers for Medicare and Medicaid Service, Medicare Advantage plans will now be able to use so-called step therapy when physicians prescribe drugs under Medicare Part B. Continue reading

Texas court decision leaves ACA in limbo

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.

A federal judge in Texas has thrown out the Affordable Care Act – every single word of the sprawling law. As Michigan law professor Nick Bagley tweeted, even the calorie counts on restaurant menus are now at risk.

The Dec. 14 Texas decision, if upheld (a big if) threatens the coverage of roughly 20 million people covered in the ACA exchanges and through Medicaid expansion. (More on the numbers at the end of this post). Continue reading

Former CMS leader discusses vulnerable populations, drug pricing and a health journalist he admires

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Donald Berwick

Don Berwick is a former administrator of the Centers for Medicare and Medicaid Services (CMS) under President Obama. Berwick’s long résumé includes leadership positions at the U.S. Preventive Services Task Force, the National Advisory Council of the Agency for Healthcare Research and Quality, the Institute of Medicine’s Governing Council, the IOM’s Global Health Board, and on President Clinton’s Advisory Commission on Consumer Protection and Quality in the Healthcare Industry. He is president emeritus of the Institute for Healthcare Improvement. He also teaches at Harvard Medical School and is on staff at several major Massachusetts hospitals.

Prior to his keynote address on social determinants of health at the recent Institute for Healthcare Improvement conference in Orlando, Fla., Berwick sat with me to talk about some of today’s most pressing health care issues. [This interview has been edited for clarity and length.] Continue reading

Primary care physicians find value-based payments fail to cover their costs

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.

It’s hard to imagine any physician starting an online fundraising effort to keep her practice open. But for Michelle Mitchell, M.D., a solo physician who runs Hawaii Family Health, the business model for primary care in her state is unsustainable otherwise.

She wants to raise $250,000 via a GoFundMe page that explains many of the financial problems she and her 15-member staff face running a practice that serves 2,500 patients in Hilo, the capital of the Big Island.   Continue reading