Tag Archives: insurance

SCOTUS ruling allows states to regulate what PBMs pay pharmacists

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 by dbking via Flickr

States seeking to regulate pharmacy benefit managers (PBMs) won an important victory on Thursday when the U.S. Supreme Court ruled 8-0, rejecting a challenge to a law the state of Arkansas passed in 2015 to put restrictions on PBMs. The ruling could allow states to regulate PBMs, as Darrel Rowland reported for The Columbus Dispatch.

Rowland is a member of an award-winning team of reporters and editors at the Dispatch who have covered PBMs in Ohio and elsewhere since January 2018, as we reported on this blog.

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Webcast to explore the high cost of failing to cover the uninsured during pandemic

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.

Clinical lab scientist Nancy Leonard prepares samples to be tested for COVID-19. She wears a face shield and gloves for protection because she is handling material that may contain the virus and will transfer patient samples into smaller tubes for testing.

Photo: Sarah Pack, Medical University of South Carolina

Leaving anyone uninsured during this viral pandemic increases the risk of spreading the disease.  A warning report on Monday from the Urban Institute projects that an estimated 25 million to 43 million Americans may lose their employer-sponsored health insurance coverage in the coming months due to the economic effects of the new coronavirus.

In “How the COVID-19 Recession Could Affect Health Insurance Coverage,” UI senior fellow Bowen Garrett and research associate Anuj Gangopadhyaya base their estimate on the possibility that the unemployment rate could reach as high as 20%. The report was produced with support from the Robert Wood Johnson Foundation. Continue reading

Scrutiny of hospital charges likely to intensify in wake of pandemic

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.

hospital-roomAs the nation’s hospitals strain to keep up with the demand to care for COVID-19 patients, it seems almost unfair to ask how much all of this treatment will cost. Still, we know that the costs will be high, both for the care itself and for what health insurers, employers and consumers will end up paying.

In a recent report, the health insurance marketplace Covered California projected that the one-year costs of testing and treatment related to COVID-19 could range from $34 billion to $251 billion. These new costs could cause health insurance premiums for individuals and employers to rise by 40% or more next year in the absence of federal action, the report said, adding that insurance premiums would increase because insurers would want to recoup any losses from the pandemic this year and plan for any future losses they might incur next year. Continue reading

Globe Spotlight journalist reports on the link between economic inequality and financial toxicity in health care

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.

health-money

Image by Colin Dunn via Flickr

Two of the biggest issues the Democratic candidates are addressing in the presidential race are economic inequality and the need to reform the health insurance system.

In 2016, Liz Kowalczyk, a health care and medical writer for The Boston Globe, rotated onto the paper’s Spotlight team for a project about race to document segregation in the city’s health care system. Soon after beginning that assignment she found an almost ideal source for one of her first articles, a nursing home worker who was diagnosed with stage three breast cancer. Continue reading

Tip sheet offers story ideas when reporting on Medicare Advantage

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic leader on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News 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.

Photo: John Jacobi via Flickr

Medicare Advantage plans may not be all they’re cracked up to be and often mislead consumers, according to a new MedPage Today story by reporter Cheryl Clark, who also is AHCJ’s new patient safety core topic leader. As Clark puts it, “getting out is a lot harder than getting in.”

Anyone turning 65 has several months on either side of their birthday to choose to enroll in traditional Medicare, the government-run health insurance for older adults and certain people under 65 with disabilities. Medicare includes Parts A (hospitalization), B (physician services) and an optional Part D (prescription drug plan). As of November, Medicare covered nearly 39 million people. Continue reading