Tag: Health Insurance and Managed Care

Merck Sues Over Medicare Drug-Price Negotiation Law

The pharmaceutical company Merck on Tuesday sued the federal government over legislation that empowers Medicare for the first time to negotiate prices directly with drugmakers. Merck’s lawsuit, filed in federal court in Washington, is the drug industry’s most significant move so far to fight back against a substantial change to health policy, which will go […]

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Hundreds of Thousands Have Lost Medicaid Coverage Since Pandemic Protections Expired

Hundreds of thousands of low-income Americans have lost Medicaid coverage in recent weeks as part of a sprawling unwinding of a pandemic-era policy that prohibited states from removing people from the program. Early data shows that many people lost coverage for procedural reasons, such as when Medicaid recipients did not return paperwork to verify their […]

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We Have Fought Anti-Trans Laws and Won Before. We Can Do It Again.

Transgender Americans are under attack. Across the country, Republicans have introduced an avalanche of legislation to restrict access to gender-affirming health care, censor how gender is discussed in schools, prevent trans people from using public bathrooms and even ban drag shows and cross-dressing onstage. In March, Tennessee criminalized drag performances where children are present. In […]

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How to Use the Debt Ceiling to Inflict Cruelty on the Poor

Seen from outside Washington, the debt ceiling battle might seem like an abstract argument between the political parties over federal spending and deficits. But for millions of low-income Americans who depend on the federal government for health care and basic nutrition, the debate is about their very lives. That’s because Republicans have singled them out, […]

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Why Undocumented Immigrants Struggle to Receive Organ Transplants

At a dialysis center in Brooklyn, Nardel Joseph used to try making friends with the other patients, until they began dying one by one. As her kidneys failed from an autoimmune disease, Ms. Joseph, 34, realized she might be next. A new kidney would offer Ms. Joseph the best hope for regaining her health, but […]

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A U.S. Experiment on Single-Payer Care Just Ended

For the last three years, the United States has been operating an experiment in single-payer health care — for one disease. That era largely came to an end last week as the public health emergency for Covid-19 expired. For Covid, the government bought vaccines and drugs in bulk and handed them out to everyone who […]

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What Does the End of the Covid Health Emergency Mean for New York City?

The official end of the nation’s Covid public health emergency on Thursday means that the country will begin to treat Covid-19 like any other transmissible disease, meaning the end of federal funds for free testing and treatment for all. In New York City, the rollback of the public health response has been underway for months. […]

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Corporate Giants Buy Up Primary Care Practices at Rapid Pace

It’s no surprise that the shortage of primary care doctors — who are critically important to the health of Americans — is getting worse. They practice in one of medicine’s lowest paid, least glamorous fields. Most are overworked, seeing as many as 30 people a day; figuring out when a sore throat is a strep […]

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Can Brandon Presley Help Mississippi Break from the Past?

Mr. Presley, 45, is one of three elected members of the state Public Service Commission, which regulates utilities, and is the former mayor of Nettleton, a small town in the bright-red northeast section of Mississippi. He talks energetically about the need to expand Medicaid and save rural hospitals, and why it’s important to eliminate the […]

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Kaiser Permanente to Acquire Geisinger

What’s Next: Regulatory Review Federal and state regulators must approve the deal. While Mr. Adams did not say what other health systems he might be talking to regarding acquisitions, Kaiser said it hoped to invest $5 billion in Risant over the next five years, in addition to its spending on Kaiser’s core operations. The company […]

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Many States Are Trying to Restrict Gender Treatments for Adults, Too

But some legislators are introducing broader bills that would prohibit gender-related care at government-owned or operated health centers, or at those that accept state funding. In Oklahoma, for example, a bill introduced this year by State Senator Nathan Dahm would withhold Medicaid reimbursement — for any procedure or treatment — from any health center that […]

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Insurers Are Starting to Cover Telehealth Abortion

The legal effort to ban mail-order abortion pills came along just as the fledgling telehealth industry became a more accepted and entrenched part of abortion care. This week, Hey Jane, one of more than a dozen virtual abortion providers that have no physical locations, began contracting with the insurers Anthem Blue Cross Blue Shield of […]

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Biden Administration Will Fund Program to Keep Covid Vaccines Free for the Uninsured

WASHINGTON — The Biden administration plans to spend more than $1 billion on a new program to offer free coronavirus shots to uninsured Americans later this year after the vaccines move to the commercial market, administration officials said. The program for the uninsured, which will be modeled partly on an existing childhood vaccination program, will […]

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Biden Administration Will Fund Program to Keep Covid Vaccines Free for the Uninsured

WASHINGTON — The Biden administration plans to spend more than $1 billion on a new program to offer free coronavirus shots to uninsured Americans later this year after the vaccines move to the commercial market, administration officials said. The program for the uninsured, which will be modeled partly on an existing childhood vaccination program, will […]

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As Mental Health Crisis Grows, More Doors Open to Care

The pandemic and its lockdowns accelerated a mental health crisis in the United States, leaving treatment providers racing to keep up with the growing demand for care. The need is acute: The National Institute of Mental Health estimated that in 2021, one in five adults in the United States lived with mental illness. To meet […]

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Will North Carolina Be the ‘Beginning of the End’ of the Medicaid Expansion Fight?

RALEIGH, N.C. — People who watch politics in North Carolina say that Phil Berger, a Republican who calls himself a fiscal conservative and a “social traditionalist,” is the most powerful man in the state. For years, as the top Republican in the State Senate, he blocked North Carolina from expanding Medicaid under the Affordable Care […]

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Millions on Medicaid May Soon Lose Coverage as Pandemic Protections End

KANSAS CITY, Mo. — In a closet-sized windowless office, Kialah Marshall maintains an Excel spreadsheet with a prosaic title, “Medicaid Unwinding,” the source material for a mind-numbing routine. Five days a week, she and a group of co-workers in a poor section of Kansas City, Missouri’s largest city, call 75 to 100 Medicaid recipients from […]

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Millions in the U.S. May Lose Medicaid Coverage. Here’s How to Prepare.

Throughout the pandemic, millions of Americans on Medicaid have been shielded from losing health care coverage. Medicaid provides health coverage for low-income Americans; for the past three years, states suspended their typical process of redetermining whether someone remained eligible for coverage. States must now reverify that every Medicaid recipient still qualifies for the program within […]

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Medicare Delays a Full Crackdown on Private Health Plans

The Biden administration on Friday finalized new rules meant to cut down on widespread overbilling by private Medicare Advantage insurance plans, but softened the approach after intense lobbying by the industry. Regulators are still moving forward with rules that will lower payments to insurers by billions of dollars a year. But they will phase in […]

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How Federal Judge’s Ruling on Obamacare Could Change Health Insurance

On Thursday, a federal judge in Texas struck down a crucial Affordable Care Act policy: the mandate that private health insurers fully cover preventive care services at no cost to patients. The ruling took effect immediately and applies nationwide. It affects dozens of potentially lifesaving preventive health care services that the federal government recommends, including […]

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When Republicans Say They Want to Protect Children, Don’t Believe Them

Here are a few of the things the Republican Party is prepared to do to protect children. The Republican Party — in states like Tennessee, Oklahoma and Kentucky — is prepared to ban or strictly limit the public performance of drag and other gender-nonconforming behavior. “This bill gives confidence to parents that they can take […]

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Obamacare Keeps Winning

The next year, voters in Idaho, Nebraska and Utah — red states, all — passed ballot initiatives expanding Medicaid. Oklahoma, Missouri and South Dakota have since done so. Montana’s state legislature has also approved an expansion. Credit…American Medical Association Communications Division In 2019, Gov. Andy Beshear of Kentucky, a Democrat, narrowly won election in a […]

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The Incredible Challenge of Counting Every Global Birth and Death

Nowhere are the disparities more apparent than in health care. Technically, it has long been available to all, thanks to the universal health care law passed when Andrés and Marleny were children. But in practice, the barriers to access are often insurmountable: a lack of reliable transportation; clinics that are understaffed and often difficult to […]

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In Mississippi, a Choice to Forgo Medicaid Funds Is Killing Hospitals

GREENWOOD, Miss. — Since its opening in a converted wood-frame mansion 117 years ago, Greenwood Leflore Hospital had become a medical hub for this part of Mississippi’s fertile but impoverished Delta, with 208 beds, an intensive-care unit, a string of walk-in clinics and a modern brick-and-glass building. But on a recent weekday, it counted just […]

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North Carolina Expands Medicaid After Republicans Abandon Their Opposition

RALEIGH, N.C. — North Carolina on Monday became the 40th state to expand Medicaid under the Affordable Care Act, the latest sign of how Republican opposition to the health measure has weakened more than a decade after President Barack Obama signed it into law. Gov. Roy Cooper, a Democrat, signed legislation expanding the state’s Medicaid […]

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A Republican Spending Problem

As congressional Republicans prepare for a budget showdown later this year with President Biden, they say that they will insist on large cuts to federal spending. So far, though, they have left out some pretty important details: what those cuts might be. Republicans have been more willing to talk about what they won’t cut. Party […]

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Trump Would Like a Word

Gail Collins: Bret, I have to admit that when the subject of Donald Trump comes up these days, I tend to start telling sex-scandal stories. My bad. Bret Stephens: Don’t let me stand in your way. Gail: Right now, that very old Stormy Daniels mess seems to have produced some very scary stuff. Our former […]

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Medicare Tries to Combat Fraud. Now Insurers Are Fighting Back.

“How’s the knee?” one bowler asked another across the lanes. Their conversation in a Super Bowl ad focused on a Biden administration proposal that one bowler warned another would “cut Medicare Advantage.” “Somebody in Washington is smarter than that,” the friend responded, before a narrator urged viewers to call the White House to voice their […]

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Biden Warns That Climate Change Could Upend Federal Spending Programs

WASHINGTON — The Biden administration will warn on Monday that a warming planet poses severe economic challenges for the United States, which will require the federal government to reassess its spending priorities and how it influences behavior. Administration economists, in an annual report, will say that reassessment should include a new look at the climate-adaptation […]

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What Old and Young Americans Owe One Another

Gratitude should lead us to make sure that older Americans can live comfortably in retirement. Solicitude should lead us to do so in ways that do not needlessly leave the next generation less prosperous than it could be. Those should be the terms of our debates about Social Security and Medicare. And they would clearly […]

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D.C. and Congress Health Data Breach Affected More Than 56,000

WASHINGTON — The data of more than 56,000 people, including Social Security numbers and other personal information, was stolen in a hack of the online health insurance marketplace for members of Congress and Washington, D.C., small businesses and residents, officials said in a statement on Friday night. The D.C. Health Benefit Exchange Authority revealed the […]

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