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Pharmaceutical companies routinely cover the cost of patient copays for expensive drugs under private insurance. A federal judge could make the practice legal for millions on Medicare as well.
Medicare has proposed revamping its payment rules to get more people into a diabetes prevention plan that helps them eat better, exercise more and maintain a healthier lifestyle. Out of an estimated 16 million Medicare beneficiaries whose excess weight and other risk factors make them eligible, only 3,600 have participated since 2018.
El acuerdo sobre el presupuesto estatal para 2021-22 incluye varias disposiciones que facilitarán el acceso y la permanencia en Medi-Cal. Todas las personas mayores de 50 años serán elegibles, independientemente de su estatus migratorio.
State lawmakers aim to expand Medicaid enrollment by dedicating billions of dollars in coming years to simplifying paperwork, extending pregnancy coverage and opening the program to thousands of new enrollees, including older unauthorized immigrants and people who need nursing home care.
Sen. Ron Wyden (D-Ore.), who is helping to negotiate the health care spending framework for the Democrats’ budget plan, said lawmakers may have to settle for very basic versions of programs deployed in the package. But the key, he added, is to get the “architecture of these changes, bold changes,” started and show people what is possible.
Democrats in Congress reached a tentative agreement to press ahead on a partisan bill that would dramatically expand health benefits for people on Medicare, those who buy their own insurance and individuals who have been shut out of coverage in states that didn’t expand Medicaid. Meanwhile, controversy continues to rage over whether vaccinated Americans will need a booster to protect against covid-19 variants, and who will pay for a new drug to treat Alzheimer’s disease. Rachel Cohrs of Stat and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews KHN’s Rae Ellen Bichell, who reported and wrote the latest KHN-NPR “Bill of the Month” episode about a mother and daughter who fought an enormous emergency room bill.
The plan from high-wire negotiations would affect five key areas of health, but there will be further tense negotiations among Democratic lawmakers about specifics of the $3.5 trillion in funding. And all Senate Democrats will need to be behind the plan, because Republicans oppose it.
Health and Human Services Secretary Xavier Becerra is the special guest for this bonus episode of KHN’s “What the Health?” podcast. He and host Julie Rovner discuss a breadth of topics the secretary oversees, including covid-19, prescription drug prices, Medicare, Medicaid and the Affordable Care Act.
In an interview for KHN’s “What the Health?” podcast, HHS Secretary Xavier Becerra says the administration is eager for Congress to make changes to Medicare that will provide more benefits and make more older adults eligible for the program. He also said a priority will be making permanent the enhanced premium subsidies for Affordable Care Act marketplace plans.
The pharmaceutical industry argues that large profits are needed to fund extensive research and innovation. But Democrats on the House Oversight and Reform Committee, seeking to bolster their effort to let Medicare negotiate drug prices, say major drug companies plow more of their billions in earnings back into propping up their stock and enriching executives and shareholders.
Aduhelm, approved by the Food and Drug Administration last month despite questions about its efficacy, could be prescribed to at least 1 million patients a year, for a price tag of about $56 billion. Experts suggest there might be better ways to spend that money.
A Trump administration rule mandating that hospitals disclose true prices on their websites took effect this year. But compliance is spotty and even when the data is public, it’s hard to find and understand.
The Biden administration is moving to undo many of the changes the Trump administration made to the enrollment process for the Affordable Care Act to encourage more people to sign up for health insurance. Meanwhile, Congress is opening investigations into the controversial approval by the Food and Drug Administration of an expensive drug that might (or might not) slow the progression of Alzheimer’s disease. Joanne Kenen of Politico, Kimberly Leonard of Insider and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews Marshall Allen of ProPublica about his new book, “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win.”
Los esfuerzos de Biden, que han sido eclipsados en gran medida por otras iniciativas económicas y de salud, representan un cambio abrupto en contra de todo lo que la administración Trump hizo para reducir el programa.
Democrats in Congress and the states are devising strategies to expand health coverage — through the Affordable Care Act, Medicare, Medicaid and a “public option.” But progress remains halting, at best. Meanwhile, lawmakers in Washington may have to agree on how to control prescription drug prices if they wish to finance their coverage initiatives. Alice Miranda Ollstein of Politico, Tami Luhby of CNN and Shefali Luthra of The 19th join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews Michelle Andrews, who reported and wrote last month’s KHN-NPR “Bill of the Month” episode about a very expensive sleep study.
In a sharp shift from Trump-era policies, President Joe Biden looks at expanding Medicaid eligibility to new mothers, inmates and undocumented immigrants and adding services such as food and housing.
In a surprisingly strong 7-2 decision, the Supreme Court turned back the latest constitutional challenge to the Affordable Care Act, likely heralding the end of GOP efforts to strike the law in its entirety through court action. Meanwhile, Democratic lawmakers are looking for ways to expand health benefits. Joanne Kenen of Politico, Mary Ellen McIntire of CQ Roll Call and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews Andy Slavitt, who recently stepped down from the Biden administration’s covid response team, about his new book on the pandemic.
Chiquita Brooks-LaSure, the new head of the Centers for Medicare & Medicaid Services, said the administration will focus on getting more people insured and is interested in finding a way to alleviate the gap keeping low-income families in states that haven’t expanded Medicaid from enrolling in Affordable Care Act health plans.
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The number of Americans 65 and older is expected to nearly double in the next 40 years. Finding a way to provide and pay for the long-term health services they need won’t be easy.