Kaiser Health News

No matter court decision, 3 insurers will stick with some of health law

As speculation over the fate of the federal health care law heightens in anticipation of the Supreme Court ruling, at least three major insurers promised Monday to continue following some of the rules in the law that already are in effect. | 06/11/12 17:59:16 By - By Julie Appleby

Same-sex partners of employees increasingly get health benefits

President Obama’s stand last week in favor of same-sex marriage has no legal effect on employers’ decisions on whether to offer benefits to workers’ domestic partners, but some advocates believe it could reinforce a decade-long trend toward coverage. | 05/14/12 18:52:04 By - By Julie Appleby

New Medicare data show disparities in health care costs

The government has identified hundreds of hospitals whose Medicare patients are incurring especially high bills, a first step toward using bonuses and penalties to encourage more efficient health care. | 05/09/12 18:09:14 By - By Jordan Rau

Health care increasingly out of reach for millions of Americans

More privately insured Americans delay treatment, while safety net programs cannot meet demand by under and uninsured. | 05/07/12 16:00:15 By - By Phil Galewitz

Battles over contraception spread, and both sides frame the struggle differently

Opponents of the Obama administration’s contraceptive coverage mandate - including likely GOP presidential nominee Mitt Romney - invoke “religious freedom.” But women’s groups and family planning organizations are convinced that the real objective is to limit access to birth control. | 04/18/12 15:50:32 By - By Judith Graham

Answers to questions about possible changes to Medicare

Congress is unlikely to consider legislation that would fundamentally restructure Medicare until a new Congress — and possibly a new president - are seated next year. But politicians have sought to tackle the growth in Medicare costs several times in the past two years, most notably in the 2010 health care law and then in last year's federal budget deal. | 04/03/12 17:36:50 By - Marilyn Werber Serafini

Health insurers push back on consumer rebate letter

Thanks to hefty profits and a requirement in the health law that takes effect this year, insurers will send subscribers hundreds of millions of dollars in rebate checks this August. But the industry and the Obama administration are at odds over proposed language in a letter that's to go out with the checks, as well as who's to be notified. | 03/29/12 17:11:34 By - Jay Hancock

Study: Paying hospitals based on quality didn't cut death rates

Medicare's largest effort to pay hospitals based on how they perform — an inspiration for key parts of the 2010 health care law — did not lead to fewer deaths, a new study has found. | 03/28/12 18:25:52 By - Jordan Rau

Health care industry weighs in — or not — on Supreme Court case

Before the raucous legislative battle to pass the health care law in 2010, there was a quieter but significant process that brought health industry players to the negotiating table. Insurers, hospitals and drug makers all cut deals to help shape what would become the Patient Protection and Affordable Care Act. | 03/22/12 16:50:33 By - Jay Hancock

If Supreme Court kills individual health mandate, then what?

When Barack Obama ran for president in 2008, he insisted the nation could fix its health care system without requiring everyone to carry insurance. As the Supreme Court prepares to weigh in on the health care law, Obama is facing the possibility that he may have to make good on his campaign claim. | 03/15/12 17:14:18 By - By Jordan Rau

Questions remain about contraceptive services under 2010 health care law

While controversy over one aspect of the Obama administration's contraception rule — whether and when religiously affiliated employers must comply — has dominated recent headlines, that debate has obscured other questions about how the rules actually will be implemented. | 02/27/12 18:06:02 By - Julie Appleby

Feds give seed money to startup health care insurance co-ops

Seven organizations will receive a total of $639 million in federal low-interest loans to launch new, consumer-governed health insurance plans in eight states, the federal government announced Tuesday. | 02/21/12 18:16:17 By - Harris Meyer

Requirements for consumer health-insurance summaries unveiled

The Obama administration has unveiled final regulations detailing the new summaries that the 2010 federal health law requires health insurance plans to give to consumers to help them make informed coverage choices. | 02/10/12 17:25:33 By - Susan Jaffe

Many states aren't ready for looming health law changes

The 2010 health law's biggest changes don't take effect until 2014, when states and insurers must be ready to begin signing up an estimated 32 million people in Medicaid and private insurance. But a successful rollout in two years hinges on crucial decisions that states must make — and take quick action on — this year. | 02/01/12 15:38:00 By - Marilyn Werber Serafini

States will get socked with new Medicaid tax under health law

Under the health care overhaul, the federal government will start taxing itself and the states beginning in 2014. And that's giving state Medicaid directors heartburn. | 02/01/12 15:37:44 By - Phil Galewitz

In quest to grow, Catholic hospital system pares religious ties

Catholic Healthcare West, one of the nation’s largest hospital systems, is ending its governing board’s affiliation with the Catholic Church and changing its name, two steps intended to help the system expand throughout the states in which it operates _ California, Arizona and Nevada _ and beyond. | 01/23/12 03:05:28 By - Jordan Rau

Despite new mandate, it's not easy to change medical practices

More than two years ago, studies found that injecting medical cement into compression fractures of the spine produced no better pain relief than "sham" injections. Yet doctors continue to perform the $5,000-plus procedure and most insurers, including Medicare, still cover it. | 01/16/12 15:26:11 By - Julie Appleby

Company accused of ripping off Medicare hospice benefits

national hospice company improperly cycled patients through nursing homes and hospices with a goal of making as much profit as possible from Medicare, according to a whistleblower lawsuit announced this week. | 01/05/12 16:11:07 By - Jordan Rau

2.5 million young adults have added health coverage, U.S. says

An estimated 2.5 million young adults have gained health insurance coverage since the 2010 health care law took effect, according to a new government survey — a finding the Obama administration is embracing as it continues efforts to communicate the health's law's benefits, even as the public's opinion about the law remains mixed. | 12/14/11 19:36:28 By - Christian Torres

Texas to shift 1 million people from Medicaid to managed care

The managed care industry's growing role in Medicaid got a boost Monday when the Obama administration approved Texas' plan to shift 1 million additional recipients into private health plans by 2013. | 12/14/11 14:54:13 By - Phil Galewitz

Health industry leaders preparing for more cuts after 2012 elections

Even as Congress' supercommittee searches feverishly for ways to reduce the federal deficit, budget and policy experts anticipate that Washington will soon face the painful task of finding even more savings. They expect health spending, which makes up more than one-fifth of the federal budget, to be at the top of the list. | 11/18/11 16:22:01 By - Marilyn Werber Serafini and Mary Agnes Carey

Deficit cutters target upper-income Medicare beneficiaries

In the scramble to come up with a deficit-reduction deal by Thanksgiving, members of Capitol Hill's supercommittee appear to have one group squarely in their crosshairs: high-income Medicare beneficiaries. | 11/14/11 16:18:16 By - Mary Agnes Carey and Marilyn Werber Serafini

Romney's plan would change Medicare fundamentally

Mitt Romney's plan to overhaul Medicare follows a familiar Republican prescription: Use the power of the marketplace to bring down costs and improve care. Yet such a move would change the nature of the popular program fundamentally, and it treads close to a House of Representatives Republican proposal that sparked controversy earlier this year. | 11/09/11 16:23:58 By - Mary Agnes Carey and Marilyn Werber Serafini

Administration releases final Medicare regulations for ACOs

The Obama administration Thursday released its much-awaited final rule for Medicare for accountable care organizations, or ACOs, which make it easier for doctors and hospitals to participate by cutting in half the number of performance measurements, removing the electronic health records requirement and eliminating financial risks for some groups. | 10/20/11 15:58:40 By - Jenny Gold and Phil Galewitz

State budget cutting prompts worries by nation's children's hospitals

In October 2010, executives from some of the largest and most prestigious children's hospitals gathered in Philadelphia to talk about the future of children's care. Panel topics ranged from the impact of the federal health overhaul law on children's hospitals to the nation's debt crisis and the significant role that health spending plays in it. | 09/25/11 01:00:38 By - Gilbert M. Gaul

A glimpse at the high pay for children's hospital CEOs

Most CEOs at the largest and richest children's hospitals are paid more than $1 million in salary and benefits annually, an analysis of hospital tax records shows. | 09/25/11 00:07:27 By - Gilbert M. Gaul

In Texas, children's hospitals expand, reshape care for kids

In Texas, everything is bigger, including the children's hospitals. Driven by a sharp increase in demand, a surplus of cash and their own outsized ambitions, children's hospitals in Texas are expanding furiously, investing billions in new facilities and services and reshaping the geography of children's care in the state. | 09/25/11 01:02:13 By - Gilbert M. Gaul

Persistence, pressure and politics paid off for Orlando children's hospital

With strict limits on medical facilities and equipment, Florida seems to set a high bar for building costly new hospitals. Among other criteria, organizations are required to show they won't duplicate existing services and drive up costs. | 09/25/11 00:01:05 By - Gilbert M. Gaul

As children's hospitals expand, costs and questions rise, too

Rising from a 60-acre field of old cypress swamp and cattle pasture near the Orlando airport, the seven-story Nemours Children's Hospital will be a monument to "best-in-class" care, its leaders boast. | 09/25/11 00:02:33 By - Gilbert M. Gaul

Obama's prescription: $320 billion in cuts to Medicare, Medicaid

In his plan to trim the federal deficit, President Barack Obama on Monday proposed $320 billion in cuts to Medicare and Medicaid, largely by changing how the federal government pays health providers, by slashing payments to drug companies and by dramatically changing the way the government splits the costs of Medicaid with the states. | 09/19/11 19:32:39 By - Phil Galewitz

Hands off Medigap, state insurance officials to tell Congress

State insurance commissioners are preparing some stern words of advice for members of Congress who are trying to reduce the federal budget deficit: Don't touch Medicare supplemental insurance. | 09/16/11 13:55:19 By - Susan Jaffe

Consumer advocates fear health law will favor business

Publicly, consumer and patient advocates continue to cheer wildly for last year's health care law. Behind the scenes, however, some worry that they're losing a few key battles to the insurance and business communities. | 09/07/11 16:06:19 By - Mary Agnes Carey and Marilyn Serafini

Federal subsidy for COBRA health coverage to expire

One of the key consumer benefits of the federal stimulus package - subsidies to help laid-off workers continue their health-care coverage - draws to a close Wednesday, raising concerns about how the unemployed will cover those expenses. | 08/30/11 18:37:07 By - Phil Galewitz

Housing bust derails path to assisted living for some

When her 86-year-old mother, a retired nurse with Alzheimer's disease, started wandering away from her Tallahassee, Fla., home in 2007, LuMarie Polivka-West knew it was time to move her mother and her 94-year-old father into an assisted-living facility. | 08/22/11 16:40:55 By - Harris Meyer

Hospitals promote bargain CT scans for worried smokers

Trumpeting a landmark study released recently, hospitals around the country have started offering deeply discounted CT scans for smokers who are worried about lung cancer. But some experts question whether the strategy is a marketing ploy that could bring more harm than good. | 08/16/11 16:31:24 By - Phil Galewitz

Pawlenty sees Minnesota health law as U.S. model

GOP presidential hopeful Tim Pawlenty scorns the health plans engineered by President Barack Obama and former Massachusetts Gov. Mitt Romney, even linking them with the term "Obamneycare." Instead, the former Minnesota governor is brandishing a health plan his state passed in 2008 as a model for the nation. | 08/09/11 16:45:51 By - Marilyn Werber Serafini

How debt deal's panel could affect health spending

The deal that President Barack Obama and Congress struck this week to raise the nation's debt ceiling calls for creating a 12-member commission made up of an equal number of Republicans and Democrats selected from the House of Representatives and the Senate that will recommend how to trim at least $1.2 trillion in federal spending over the next decade. | 08/04/11 18:09:35 By - Mary Agnes Carey and Phil Galewitz

Report: Health care law has limited impact on spending

The 2010 federal health care law will have little effect on the nation's rising health spending in the next decade, a government report said Thursday. Health care law critics said the report confirmed their concerns. | 07/28/11 03:00:00 By - Phil Galewitz

HHS rules on health marketplaces give states flexibility

State flexibility takes center stage in proposed federal rules governing marketplaces where individuals and small businesses can shop for health insurance starting in 2014. The long-anticipated rules, released Monday, are less prescriptive than some consumer advocates desired, but they grant states' requests that they get broad leeway to design and regulate the marketplaces, called exchanges. | 07/11/11 19:20:24 By - Julie Appleby and Christopher Weaver

Health law on expatriates will hurt business, insurers say

Some of the nation's largest insurers are complaining that the Obama administration isn't doing enough to ease health law requirements that they say threaten their ability to sell health coverage for millions of Americans who work abroad. | 07/06/11 15:04:39 By - Phil Galewitz and Christopher Weaver

New health-plan forms put through acid test: Focus groups

Starting next March, insurers and employers will have to make it easier for consumers faced with the ordeal of picking health plans. Under the 2010 health care law, they'll have to provide health policy information that the average enrollee can understand and use to compare with other plans. | 06/21/11 17:12:51 By - Susan Jaffe

Medicare panel urges crackdown on excessive MRIs

An influential independent congressional advisory group is urging lawmakers to crack down on doctors who order too many MRIs for seniors, setting off a battle with physicians and patient groups who argue that Medicare beneficiaries might suffer significant delays in treatment. | 06/15/11 15:54:13 By - Marilyn Werber Serafini and Mary Agnes Carey

Obama to lower premiums for high-risk insurance plans

Trying to spur enrollment in a key new benefit of the 2010 health law, the Obama administration said Tuesday that it's slashing premiums for new high-risk insurance plans and no longer requiring applicants to submit a rejection letter from private insurers. | 05/31/11 15:41:50 By - Phil Galewitz

Conservative seniors group defends Ryan Medicare plan

Jane Corwin's defeat in a New York state primary raises questions whether 60 Plus, a 19-year-old organization that over the last year has become increasingly active in pushing Republican candidates and causes, will be effective in next year's elections. Corwin and 60 Plus had backed Paul Ryan's proposal to sharply transform Medicare. | 05/26/11 18:30:04 By - Marilyn Werber Serafini and Bara Vaida

GOP: Feds should let states tighten Medicaid eligibility

With their proposal to turn Medicaid into block grants all but dead, Republicans are pushing legislation to let states tighten eligibility rules for the health program for poor people and those with disabilities. The move would help cash-strapped states save money, but it also could cause hundreds of thousands of people to lose health coverage. | 05/24/11 13:25:10 By - Mary Agnes Carey and Phil Galewitz

Health insurers' rate increases to be scrutinized more closely

Health insurers seeking rate increases of 10 percent or more will face increased scrutiny starting in September under rules the Obama administration finalized Thursday. | 05/19/11 18:33:28 By - Julie Appleby

Florida pushing new fees for most Medicaid recipients

Florida wants to be the first state in the nation to charge most of its Medicaid recipients a monthly premium as well as $100 for using the ER for routine care. But even supporters acknowledge that the new fees, which the state legislature passed recently as part of a sweeping Medicaid measure, face long odds of getting federal approval | 05/17/11 15:55:50 By - Phil Galewitz

Nine states appeal federal rule limiting health insurers' profits

In a move that could absolve health insurers of paying more than $95 million in consumer rebates, nine states are pressing for relief from a federal rule limiting insurers' profits and administrative costs. | 05/10/11 17:00:25 By - Julie Appleby

Insurers: Lots of young adults joining parents' health plans

Hundreds of thousands of young adults are taking advantage of the 2010 health care law provision that allows people younger than 26 to remain on their parents' health plans, some of the nation's largest insurers are reporting. That pace appears to be faster than the government expected. | 05/04/11 16:09:20 By - Phil Galewitz

More states moving to managed-care plans for Medicaid

Lobbying battles are being fought in state capitals across the country as more than a dozen governors try to contain the cost of Medicaid, the state-federal program for the poor and those with disabilities, by requiring more people to go into managed-care plans. | 04/26/11 17:32:19 By - Phil Galewitz

CBO: Seniors would pay much more for Medicare under Ryan plan

Seniors and people with disabilities would pay much more for Medicare under a new plan by Republicans in the House of Representatives that's aimed at curbing the nation's growing budget deficit, a Congressional Budget Office analysis shows. | 04/06/11 17:07:04 By - Julie Appleby, Mary Agnes Carey and Laurie McGinley

'Accountable care' expected to save millions for Medicare

The Obama administration released proposed rules Thursday to help hospitals and doctors form a new type of health care delivery system called accountable care organizations, and officials estimated the ACOs could save Medicare up to $960 million over three years. | 03/31/11 17:20:56 By - Phil Galewitz, Jordan Rau and Bara Vaida

Agencies slam new Medicare rule on home care

Home health agencies, hospitals and consumer groups are complaining that a new rule intended to curb unnecessary Medicare spending will make it harder for senior citizens to get home care services. | 03/25/11 19:21:25 By - Phil Galewitz

Mississippi's Barbour seeks more state control of Medicaid

Mississippi Gov. Haley Barbour raised eyebrows in Washington last week when he said some Medicaid recipients in his state drive BMWs. But back home, Barbour's critics weren't surprised. | 03/11/11 15:02:56 By - Julie Appleby

Arizona Medicaid cuts have hidden costs, providers say

Arizona's plan to cut about a quarter-million adults from Medicaid would lead to uninsured patients crowding emergency rooms, hospitals slashing services and laying off thousands of workers and health plans increasing premiums to make up for lost revenue, health providers say. | 03/02/11 14:12:32 By - Phil Galewitz

Feds help states seeking to cut Medicaid rolls

By telling Arizona Tuesday it can effectively end Medicaid coverage of a quarter million people, the Obama administration has pointed out a potential escape hatch for other financially strapped states seeking to cut people from the program. It’s just not clear how big the hatch is. | 02/17/11 09:43:41 By - Marilyn Werber Serafini

States wanting to cut Medicaid rolls may face showdown with feds

Financially strapped governors, Congress and the Obama administration could be headed for a showdown over the Medicaid health care program, which covers 48 million poor, disabled and elderly people nationwide. | 01/31/11 16:16:38 By - Marilyn Werber Serafini and Julie Appleby, Kaiser Health News

Here's how GOP wants to 'prune' health care law

The Republican effort to repeal the health care law is sure to founder in the Democratic-controlled Senate, but that doesn't mean the GOP is ending its attempts. Republicans in the House of Representatives already are beginning work in committees to lop off and possibly replace some of the law's provisions. | 01/24/11 18:52:22 By - Lexie Verdon, Bara Vaida and Jordan Rau, Kaiser Health News

Accountable care organizations: The next big thing in health care

Accountable care organizations take up only seven pages of the massive new health care law, yet they've become one of the most talked about provisions. This latest model for delivering services offers doctors and hospitals financial incentives to provide good quality care to Medicare beneficiaries while keeping down costs. | 01/19/11 15:12:16 By - Jenny Gold, Kaiser Health News

Hospitals try new ways to curb emergency room crowding

When Katherine "Kitty" Foley tripped over a trailer hitch at last year's JazzFest in New Orleans and broke her wrist, she put up with the pain until the Average White Band finished its set. As a nurse, she knew she needed prompt care, but she dreaded a long, unpleasant wait in a crowded hospital emergency room. When she did get to Ochsner Medical Center, she was stunned. | 01/18/11 11:57:01 By - Joanne Kenen, Kaiser Health News

Feds to decide what benefits health insurers must cover

Even as House Republicans vow to repeal the health care law, government advisers are preparing this week to wade into one of the most contentious questions the legislation raises: What benefits must insurers cover? | 01/10/11 16:06:41 By - Julie Appleby, Kaiser Health News

Obama takes steps to cap health insurance rate increases

Health insurers that are seeking a rate increase of 10 percent or more in 2011 must detail publicly why the increase is needed, under proposed rules that the Obama administration released Tuesday. The states, and in some cases, the federal government would then review the proposed rates to determine if they're reasonable. | 12/22/10 06:33:38 By - Julie Appleby, Kaiser Health News

New poll undercuts GOP claims of a midterm mandate

A majority of Americans want the Congress to keep the new health care law or actually expand it, despite Republican claims that they have a mandate from the people to kill it, a new McClatchy-Marist poll shows. The poll also shows that a majority also wants to end the Bush-era taxcuts for the wealthy. | 11/22/10 18:11:36 By - Steven Thomma

Debt experts: Let's make Medicare beneficiaries pay more

Offering the latest tough-love strategy to reduce the nation's debt, a panel of high-profile Republicans and Democrats is scheduled on Wednesday to recommend that Medicare beneficiaries pick up far more of their health care costs and that the government substantially curb the amount both Medicare and Medicaid programs can grow in future years. | 11/16/10 20:26:59 By - Phil Galewitz and Jordan Rau, Kaiser Health News

Advocates begin to fight back over GOP plans to gut health care law

In the aftermath of Republicans' election victories, defenders of the health care law are huddling - once again - in an effort to thwart GOP efforts to eviscerate the sweeping measure. | 11/10/10 17:52:25 By - Mary Agnes Carey

House takeover would give GOP ways to attack health law

If Rep. Joe Barton becomes the chairman of the House Energy and Commerce Committee next year, the Texas Republican vows to make life miserable for Democratic defenders of the health care overhaul law. | 11/01/10 19:42:13 By - Marilyn Werber Serafini

Three states to vote on health insurance mandate

Voters in Arizona, Colorado and Oklahoma will have the chance Tuesday to repudiate the new federal health care law's keystone provision, one that requires almost everyone to have health insurance or face a tax penalty beginning in 2014. | 10/31/10 15:05:40 By - Aimee Miles, Kaiser Health news

Union-backed groups oppose GOP Medicare voucher plan

Cat food wasn't on the menu at a recent book launch party for "Young Guns: A New Generation of Conservative Leaders." But that didn't stop representatives of the labor-backed Alliance for Retired Americans from handing out cans of the stuff to arriving partygoers at the fashionable Johnny's Half Shell, a few blocks from the U.S. Capitol. The less-than-subtle protest targeted Republican proposals in the book to privatize Social Security and turn Medicare into a voucher program. | 10/28/10 17:02:56 By - Marilyn Werber Serafini

State regulators recommend new health insurance rules

State insurance regulators on Thursday unanimously recommended controversial rules that govern how much insurers must spend on patients' medical care, and they chose not to adopt any of several amendments that consumer advocates had feared would gut key provisions. | 10/21/10 16:10:49 By - Julie Appleby, Kaiser Health News

Insurer tries new way of paying doctors to treat cancer

One of the nation's largest health insurers said Wednesday that it was testing a new way to pay for some cancer treatments, aiming to identify the best medicines and to limit doctors' profits from dispensing in-office chemotherapy drugs. | 10/20/10 16:45:24 By - Julie Appleby, Kaiser Health News

Sebelius: Enrollment rules must be the same for healthy, sick children

Some insurers want to allow healthy children to enroll year-round but only have a limited enrollment window for those with pre-existing conditions. Not so fast, Health and Human Services Secretary Kathleen Sebelius said Wednesday in a letter to the National Association of Insurance Commissioners. | 10/13/10 20:54:26 By - Mary Agnes Carey, Kaiser Health News

New report calls for greater role for nurses in medical care

The report, released by the Institute of Medicine and sponsored by the Robert Wood Johnson Foundation, says nurses should take on a larger and more independent role in providing health care in America, something doctors have long opposed. It calls for governments to remove limits on what care advanced practice nurses — those with a master's degree — provide. | 10/05/10 07:48:05 By - Andrew Villegas and Mary Agnes Carey

Sick kids get new insurance protections, but hurdles remain

When an insurance company refused to cover Deborah Gustlin's son because he has Asperger's syndrome, she took a drastic step. | 09/23/10 18:07:06 By - Laurie McGinley and Mary Agnes Carey, Kaiser Health News

8 health law changes that just began — with 7 caveats

If you've tuned out the new health care law, you might want to tune back in. A set of new consumer protections went into effect Thursday, the six-month anniversary of the law. | 09/23/10 16:44:07 By - Mary Agnes Carey, Kaiser Health News

GOP plan to change health law could bring complications

Republicans, buoyed by recent polls that found that their party could win the House of Representatives and pick up seats in the Senate in November, are vowing to repeal or vastly revise the health overhaul law that Democrats squeezed through Congress last spring. How difficult would it be to overturn that law, though? | 09/20/10 15:44:57 By - Mary Agnes Carey, Kaiser Health News

Colleges say new health law may imperil student policies

Colleges and universities say that some rules in the new health law could keep them from offering low-cost, limited-benefit student insurance policies, and they're seeking federal authority to continue offering them. | 08/23/10 14:47:31 By - Julie Appleby, Kaiser Health News

Medicare Advantage's benefits, and cuts, vary by state

For the 11 million people signed up for Medicare Advantage plans, their future with the popular program may depend on where they live. To help finance the health care overhaul legislation, Congress cut $136 billion over 10 years from the program, in which private insurers provide Medicare health plans for seniors. The private plans, which the government pays a flat fee for each enrollee, were a likely target: They cost the government much more per beneficiary, on average, than traditional Medicare does, according to Medicare's advisory commission. | 08/11/10 12:48:55 By - David Gulliver, Kaiser Health News

High-risk health insurance pools to bar abortion coverage

Elective abortions will be prohibited and people with pre-existing conditions will be able to get comprehensive benefits without paying any more than healthy people under new federal regulations for high-risk health insurance pools released Thursday by the Obama administration. | 07/29/10 19:45:09 By - Phil Galewitz, Kaiser Health News

Coming health care changes you may not know about

Several little-known provisions of the new health care overhaul law take effect in coming months that could have a lasting impact on the nation's health care system. | 07/09/10 14:23:10 By - Mary Agnes Carey and Andrew Villegas

Feds to states: Explain high-risk insurance pool plans

Federal officials, eager to launch one of the signature programs of the new health care law, have told states that they must provide more information by the end of next week on how they intend to run the high-risk health insurance pools. | 06/18/10 15:16:28 By - Mary Agnes Carey, Kaiser Health News

New health care rules for employers draw mixed reaction

Business groups gave mixed reviews this week to new Obama administration rules limiting how much employers and insurers can change their health insurance plans while remaining exempt from potentially costly new consumer protections. | 06/15/10 15:54:26 By - Phil Galewitz and Mary Agnes Carey, Kaiser Health News

COBRA subsidy starts expiring as Congress grapples with extension

Howard Kornblum has been watching every penny for the past 15 months, and it's about to get worse. After being laid off from his job as a consulting director in Michigan, he took advantage in March 2009 of a federal subsidy to help pay for health insurance. With the government picking up 65 percent of the tab, Kornblum's share of the premiums was $236 a month. On Tuesday, the subsidy expired for the first people who got it | 06/04/10 15:18:43 By - Andrew Villegas, Kaiser Health News

Health law's benefits may hinge on a word: 'grandfathered'

Millions of Americans could lose some important benefits of the new health overhaul law depending on how the Obama administration chooses to interpret one term: "grandfathered." Under the law, existing, or "grandfathered" health plans are exempt from several consumer protections. | 05/10/10 17:54:13 By - Phil Galewitz and Mary Agnes Carey, Kaiser Health News

Health officials, nonprofits split on how to spend prevention funds

There's a sharp divide over how to spend a $15 billion disease "prevention" fund over the next decade, and public health officials and nonprofit groups are pushing competing strategies. | 05/07/10 14:45:36 By - Julie Appleby, Kaiser Health News

Health coverage delayed for adult children of federal workers

Many parents breathed a sigh of relief when they heard that health insurance companies were opening up coverage to young adult children under the new healthcare law. However, lots of others — including those whose parents who work for the federal government — probably won't be able to get that coverage until next year. | 04/27/10 19:12:57 By - Jessica Marcy, Kaiser Health News

Health law includes novel long-term care insurance

A provision in the health care overhaul law signed by President Barack Obama last month could help people care for the disabled. The law establishes a voluntary, long-term care program that will provide cash to enrollees who suffer at least two limitations in daily activities, such as eating, bathing and dressing. | 04/15/10 18:28:34 By - Harris Meyer, Kaiser Health News

Health care law's rules on young adult coverage still unknown

Beginning in September, young adults can remain on their parents' insurance policies, even after they've ceased being full-time students. But how exactly the new law will work still awaits complex rule writing by the federal government. | 04/01/10 18:56:00 By - Michelle Andrews

States can start new Medicaid expansion Thursday

Starting Thursday, states can choose to take the first steps toward the massive expansion of insurance coverage that is the recent health overhaul legislation's chief goal. For some states, that move could have the benefit of reviving funding for state-run programs that insure low-income adults. | 03/31/10 18:43:33 By - Christopher Weaver, Kaiser Health News

How Medicare's drug 'doughnut hole' will be filled

Now that the health care overhaul has passed Congress, Democratic lawmakers are hoping to highlight its most immediate benefits. Chief among them: a plan to help millions of elderly and disabled Medicare beneficiaries pay for their medications by gradually eliminating a prescription-drug coverage gap commonly known as the "doughnut hole." | 03/29/10 16:26:36 By - Christopher Weaver, Kaiser Health News

Congress sacrificed many of health bill's provisions

In the year it took Congress to write and pass a health care overhaul, turbulent political shifts — including the Democrats' loss of the seat long held by the late Sen. Edward Kennedy and the rise of the Tea Party movement — forced critical compromises on the scope of legislation. | 03/23/10 15:16:16 By - Jordan Rau

Will immediate health care benefits help elect Democrats?

Obama administration officials and wonks call them "early deliverables." They're the benefits of the health care legislation that would kick in this election year. | 03/22/10 14:47:48 By - Julie Appleby and Kate Steadman, Kaiser Health News

Revamped health care bill has 9 major changes

In their attempt to pass a sweeping health care overhaul this weekend, Democrats in the House of Representatives are pushing a package of legislative revisions to lure undecided or opposed members of their party to the "yes" category. | 03/19/10 20:00:35 By - Julie Appleby and Mary Agnes Carey, Kaiser Health News

More states taxing hospitals to shore up Medicaid

Georgia Republican Gov. Sonny Perdue, wrestling with a massive hole in the state's Medicaid budget, has proposed a new tax on hospitals and managed care plans. In addition, hospitals in Iowa and Tennessee, as well as in rural Wisconsin, are calling for higher taxes — on themselves. | 03/18/10 16:24:02 By - Andy Miller, Kaiser Health News

Powerful Catholic quietly shapes abortion, health care debate

Richard Doerflinger doesn't look the part of a high-powered political strategist. Bearded and bespectacled, he works in a small, cluttered office out of one of Washington's less-fashionable neighborhoods, far from the lobbying bastions of K Street. | 03/10/10 15:41:20 By - Laura Parker, Kaiser Health News

Doctor shortage fuels nurse practitioners' push for bigger role

There are no doctors in rural Tyrrell County, N.C. There's only Irene Cavall, a licensed nurse practitioner and the sole source of primary care for 4,000 residents spread out over 600 square miles. | 02/22/10 19:03:56 By - Andrew Villegas, Kaiser Health News

Will health savings go to reduce deficit rather than expand coverage?

In their effort to overhaul the health care system, President Barack Obama and congressional Democrats pressed hospitals, drug makers and other providers to accept billions of dollars in government payment cuts and new fees to help finance the legislation. | 02/16/10 20:01:36 By - Mary Agnes Carey

Obama's budget would boost funds for health research

The Obama administration, in an effort to forge ahead with its controversial effort to compare various medical treatments, is proposing a big boost in funding for the agency that oversees the research. | 02/02/10 20:01:53 By - Mary Agnes Carey and Julie Appleby

Is health overhaul possible without requiring coverage?

With a major health overhaul in deep trouble, some lawmakers want a scaled-back approach that targets the indisputably unpopular insurance industry, by enacting such popular ideas as requiring insurers to accept people with medical problems and barring them from canceling policies or charging more for customers with health problems. | 01/26/10 20:02:21 By - Julie Appleby and Jenny Gold

How Democrats could pass health bill with 51 votes (it isn't pretty)

Democratic leaders, who no longer have a filibuster-proof majority in the Senate, are weighing the use of arcane budget rules to pass at least part of the long-debated health overhaul package. | 01/21/10 20:02:42 By - Eric Pianin

What Congress' health care overhaul likely means for you

Now that the Senate has passed a hotly debated health care bill, Congress is headed to the next step: House of Representatives-Senate negotiations in January to hammer out a final version. Given the Senate's difficulty in passing a bill, the final legislation is likely to tilt strongly toward that chamber's version. Here's where things stand and how you might be affected. | 12/24/09 20:01:16 By - Jordan Rau

Survey: 'Cadillac tax' would lead employers to trim costs

Two-thirds of employers would raise deductibles, change insurers or scale back coverage to avoid the so-called "Cadillac tax" on high-cost benefits proposed in the Senate Democrats' health care bill, according to a survey to be released Thursday by consulting firm Mercer. | 12/02/09 19:16:20 By - Julie Appleby

How the House abortion restrictions would work

The health care bill that the House of Representatives has passed would bar insurers from selling policies that cover abortion to anyone who gets a federal subsidy. It does allow insurers to offer optional abortion coverage that consumers could purchase with their own money. Based on some states' experiences, however, it's unlikely that insurers would sell such coverage. | 11/11/09 15:48:32 By - Julie Appleby

Congress often blocks Medicare changes that would cut costs

The Democratic health care legislation comes studded with cautious plans to test proposals for reining in Medicare costs. History suggests, however, that even if the experiments are successful, the odds aren't high that their lessons will be applied to the entire program. | 11/03/09 15:36:48 By - Christopher Weaver and Kate Steadman

Commission to rein in federal entitlement costs is proposed

Amid signs that health care overhaul legislation will do little to slow the growth in health care spending in the coming decade, lawmakers and Obama administration officials are considering tougher steps to rein in soaring budget deficits. | 10/27/09 14:43:37 By - Eric Pianin

How 'trigger' approach could help health care bill pass

The so-called "trigger" approach would hold a public option health insurance plan in reserve and allow it to go forward only if affordable insurance isn't available to most Americans by 2013. | 09/10/09 18:38:12 By - Eric Pianin and Mary Agnes Carey

Proposed cuts to Medicare private plans worry seniors

Seniors have embraced privately run Medicare health plans that offer benefits that go well beyond ones offered by traditional Medicare. But they're expensive for the government, which pays the premiums. Obama would like to cut $177 billion in federal payments to the private plans to help finance coverage for the uninsured. | 09/08/09 18:39:29 By - Phil Galewitz

Health bills might not protect needy Americans

Patrick Gilbert, an uninsured lumber company worker in upstate New York, is in a predicament that President Barack Obama and congressional Democrats believe they can solve. Gilbert and his wife have two children, but he says that on his family's $50,000 annual income, he can't afford the $600 monthly premiums for his employer's health-insurance coverage. | 09/04/09 15:51:27 By - Jordan Rau

Health care ad audit: 'Mean for You'

This is one of a series of features analyzing advertisements sponsored by organizations that are engaged in the debate over health care. AD TITLE: "Mean For You" SPONSOR: Americans for Stable Quality Care | 08/24/09 17:39:53 By - Jordan Rau

Out-of-network costs cripple many patients financially

Gary Diego's story is an extreme example of what can happen in medical emergencies. Consumers who are careful to choose in-network doctors and hospitals for their routine medical care often can't choose where or how they are treated in an emergency. In a practice known as balance billing, insurers pay a portion of the out-of-network charges, and the balance owed to hospitals and doctors is dumped on patients. | 08/20/09 17:43:11 By - Paul Raeburn

With opposition mounting, Dems need health-care alternative

Relentless attacks on President Barack Obama's health care overhaul effort, coupled with continued questions about how to pay for it, are prompting analysts to suggest that Democrats will have to scale back the cost and scope of the legislation to get anything through Congress this year. | 08/20/09 17:42:53 By - Eric Pianin and Mary Agnes Carey

Tech-savvy Seattle finds electronic health records no cure-all

Atop a hill in Seattle, three of Washington state's pre-eminent hospital systems sit within blocks of one another, equipped with state-of-the-art electronic medical-record systems that track test results, send warnings about dangerous drug interactions and provide medical histories. Here's what patients know, however: The systems, made by different manufacturers, can't talk to each other. | 08/11/09 07:43:09 By - Julie Appleby

Health overhaul's advocates fear side effects of cost cuts

As Congress continues to try to scale back the costs of health care legislation, some patient advocates, health care policy analysts and lawmakers fear the plan may be pared to the point of leaving millions of Americans with either inadequate benefits or large out-of-pocket costs. | 07/27/09 16:17:25 By - Jordan Rau and Eric Pianin

Are big insurance discounts for healthy behavior unfair?

Employers and health insurers could give larger discounts to employees who lose weight or lower their cholesterol under one health care overhaul proposal that's moving through Congress. But the AARP, the American Heart Association and other groups think it's unfair and fear it could result in higher premiums for people who don't achieve those fitness goals. | 07/27/09 16:17:11 By - Mary Agnes Carey

In the healthcare debate, a long list of ways to pay is considered

Scrambling for additional money to pay for a health care overhaul, Senate Democrats are eyeing the insurance industry for as much as $100 billion over 10 years. But the ideas they're exploring, including taxing companies that sell costly policies and imposing a "windfall" tax on profits, all have drawbacks and could have unintended consequences. | 07/26/09 16:34:44 By - Julie Appleby

Rural lawmaker feels competing pressures in health debate

Residents of Rep. Mike Ross's economically struggling Arkansas district are looking to Washington for help with skyrocketing health care costs. Yet Ross, a Democrat, stands ready to try to block the passage of a House bill that supporters say is what his constituents need. | 07/22/09 17:05:35 By - Eric Pianin and Ann Carrns

Administration Facing Tough Sell To Doctors On Health IT

Dr. David Blumenthal, the Obama Administration's national coordinator for health information technology, can recall the day he became a true believer in the potential of electronic health records. He was about to order a lung scan when the computer in his Boston hospital alerted him to a similar image already in the file. The patient was spared an unnecessary dose of radiation and the health care system was spared the cost of an unnecessary test. | 07/19/09 21:19:11 By - Christopher Weaver

States moving to expand long-term care insurance

Joe Donahue's mother, Alice, spent her last three years in a Connecticut nursing home, slowly succumbing to Alzheimer's disease. By the time she died in 1990 at age 86, her modest estate — about $200,000 — had been used up to pay for her care. | 07/16/09 12:50:55 By - Michelle Andrews

Health legislation might bar some from public insurance

President Barack Obama and leading Democrats have stressed that people who like their employer-sponsored insurance would be able to keep it under a health care overhaul. They haven't emphasized the flip side, however: that people who don't like their coverage might have to keep it. | 07/15/09 17:19:08 By - Mary Agnes Carey and Julie Appleby

Health care ad audit: 'Health Reform Testimonials'

This is one of a series of features analyzing advertisements sponsored by organizations that are engaged in the debate over health care. | 07/14/09 12:02:18 By - Kaiser Health News

Liberals brace for fight over scope of health legislation

As leaders in the House of Representatives prepare to release a sweeping health care overhaul plan, they're clinging to their goal of providing a liberal counterpoint to any such legislation that's now likely to emerge from the Senate. | 07/13/09 15:20:27 By - Eric Pianin and Jordan Rau

Health insurance exchanges offer consumers new options

When Michael Kovner decided to buy health insurance earlier this year, he logged on to his computer, entered his age and ZIP code on a special Web site and studied the nearly 20 different policies that popped up. Within a half-hour, Kovner, a 53-year-old technology consultant, picked a midpriced one and clicked "enroll." Back came an immediate e-mail confirmation: "Congrats, you're in." | 07/13/09 15:13:39 By - Julie Appleby

Hospitals agree to funding cuts but oppose government insurance

With the Obama administration's help, hospitals are moving aggressively to resolve their biggest objections to legislative proposals to overhaul the health care system. | 07/08/09 15:47:38 By - Eric Pianin and Phil Galewitz

Advocates of full nationalized health insurance fight on

The YouTube video shows Donna Smith pulling on a white hazmat suit and protective rubber gloves. She's going to work, trying to clean up the nation's health insurance industry. | 07/07/09 18:40:34 By - Rick Schmitt

How to pay for health care reform? Maybe these new taxes

Democratic leaders, worried that high price tags might derail their health care plans, are looking at a raft of ideas both old and new to salvage their legislation. Among the possibilities: a value-added tax, a 2 percent surtax on the wealthy, and a tax on soft drinks. | 07/07/09 18:43:00 By - Jenny Gold, Eric Pianin and Julie Appleby

Electronic prescriptions move health care into digital future

At first, Dr. Marek Durakiewicz welcomed the opportunity to send prescriptions to drugstores electronically, using free computer equipment provided by a state pilot program. | 07/07/09 18:41:52 By - Ann Carrns

How much do you know about Medicaid? A true-false test

With 60 million enrollees, Medicaid dwarfs other insurance programs, including its cousin, Medicare, which covers 44 million elderly and disabled people. Test your knowledge of Medicaid. | 07/07/09 18:41:11 By - Phil Galewit

Medicaid could help cover more uninsured, but not everyone's sold

Medicaid's role in health care is emerging as a flashpoint, exposing policy and political rifts not only between the two parties but also among Democrats themselves. | 07/07/09 18:41:33 By - Mary Agnes Carey

Democrats hint compromise to win Senate health care deal

Senate Democrats are offering to scrap a controversial government-sponsored health insurance provision in an effort to win more than a dozen moderate and conservative Republican votes to extend health care coverage to nearly 46 million uninsured Americans. | 07/07/09 18:45:18 By - Mary Agnes Carey and Eric Pianin

Ex-Senate leaders unveil compromise plan for health care

Three former Senate majority leaders unveiled a bipartisan health care package Wednesday that would tax health benefits for some Americans and require insurance coverage for all. | 07/07/09 18:44:49 By - Andrew Villegas

A health-care exchange of sorts already exists: barter

With no health insurance and little money, Gilberto Carrasco, a Reno, Nev., auto mechanic, didn't see much point in getting a physical. At 50, he felt healthy and couldn't afford treatment even if a doctor found a medical problem. | 07/07/09 18:43:49 By - Rochelle Sharpe

How Congress' number-crunchers affect debate on health care

A congressional budget agency little known outside Washington once again has demonstrated the power of number-crunchers to drive policy. | 07/07/09 18:43:25 By - Eric Pianin and Mary Agnes Carey

Health bill needs seniors' support, but there's little in it for them

In many ways, seniors have the least to gain from an overhaul of the health care system. Thanks to Medicare, they're the only age group that already has universal coverage, and they've had a drug benefit since 2006. | 07/07/09 18:42:34 By - Phil Galewitz

Obama's Challenge: Selling Health Reform to the Middle Class

From the beginning, President Barack Obama and his top advisers have sought to portray health care reform not just as another costly entitlement for the poor, but as part of a larger effort to ease the burden of mounting medical costs for the middle class. | 07/07/09 18:42:12 By - Eric Pianin

White House close to deal with hospitals on cost cuts

The hospital industry is close to a deal with the White House and congressional Democrats in which the industry would agree to federal funding cuts of $150 billion to $170 billion over the next decade to help pay for a health system overhaul, according to people familiar with the talks. | 07/07/09 18:40:48 By - Laurie McGinley and Phil Galewitz

Small business divided over requiring employer health care

With 68 million workers, small businesses will have big clout in deciding the fate of President Barack Obama's effort to overhaul the health care system. In 1994, the small-business lobby, led by the National Federation of Independent Business, helped kill the Clinton administration's plan, partly because it included an employer mandate. | 06/16/09 18:23:48 By - Mary Agnes Carey

Commentary: Solving the political paradox of health care reform

After decades of effort, the enactment of universal health insurance coverage is actually in sight. Its absence has cost us — as individuals and as a nation — a fortune, as the recent report from President Barack Obama's Council of Economic Advisers reminds us.

Affordable health care coverage for everyone is critical to long-run fiscal stability and to the economic and health well-being of the American people. | 06/12/09 06:13:04 By - Judy Feder

How much clout will labor have in health care debate?

This should be labor's big moment: a Democratic White House and Congress poised to overhaul the nation's health care system. Despite spending more than $113 million to help elect their ideological allies last November, unions are having a challenging time getting their way on Capitol Hill. | 06/11/09 15:59:04 By - Jordan Rau

Democrats' draft health bill delays GOP confrontation

Democrats on the Senate Health, Education, Labor and Pensions released their health care proposal Tuesday, but left out for now the two elements Republicans dislike the most — a new government-run insurance plan and a requirement that employers provide coverage or pay a penalty. | 06/11/09 12:56:27 By - Mary Agnes Carey

Daschle gives Obama's health care plan a 50-50 chance

Even as President Barack Obama set August as a "make-or-break" deadline for overhauling the health care system, Tom Daschle, who was the president's first choice to run the effort, predicted just a "50-50 chance that something's going to pass." | 06/11/09 12:55:40 By - Jenny Gold

Q&A: Major changes loom for nation's health care system

With Congress working on a sweeping health-care overhaul, questions abound for consumers, including whether people might have to change their insurance or buy coverage if they don't have it. Here's a guide to the top issues. | 06/11/09 12:55:26 By - Mary Agnes Carey

Blue Dog Democrats could have major role in shaping health bill

President Barack Obama is moving quickly to head off opposition to major health care legislation from fiscal conservatives in Congress by vowing to follow strict rules for paying for it without further driving up the already huge deficit. | 06/11/09 12:56:27 By - Eric Pianin

Democrats in Congress begin to craft health-care legislation

Democratic leaders in the House of Representatives will begin preliminary consultation Tuesday with rank-and-file members over the ultimate shape of the bill that could expand coverage to the 46 million uninsured Americans and possibly create a government health insurance entity. | 06/11/09 12:56:27 By - Mary Agnes Carey and Eric Pianin

How Congress might tax your health benefits

If you work at a company that reimburses employees for joining a gym, you pay income taxes on the value of that perk. If you get life insurance through work, there's a good chance that you pay taxes on a portion. Health benefits could be next. | 06/11/09 12:56:27 By - Julie Appleby

Many health insurers have their own assessment panels

As many patients discover, doctors don't have the last word on treatment. Insurers generally deny coverage for anything they think hasn't been proved to work. | 06/11/09 12:56:27 By - Harris Meyer

Washington state health panel could be model for U.S.

When it's judging the value of medical treatments it pays for, Washington state imposes a tough standard, the kind that might save tens of billions of dollars a year if it were applied nationally. | 06/11/09 12:56:27 By - Harris Meyer

Fate of Obama health care plan is anything but certain

History is clear: When it comes to something as contentious as overhauling the health care system, there are no safe bets. Presidents from Theodore Roosevelt to Richard Nixon to Bill Clinton failed at ambitious attempts to change the health care system, and "you might argue, based on history, that that's the most likely scenario," says Michael Cannon, director of health policy studies at the Cato Institute, a libertarian think tank in Washington. | 06/11/09 12:55:05 By - Julie Appleby and Mary Agnes Carey

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ABOUT THIS SECTION

Kaiser and McClatchy

Kaiser Health News (KHN) is a nonprofit news organization committed to in-depth coverage of health care policy and politics. Kaiser Health News is funded by the Kaiser Family Foundation, a non-profit private operating foundation based in Menlo Park, Calif., which is dedicated to producing and communicating the best possible analysis and information on health issues.


KHN’s editors decide what stories its staff will cover, and McClatchy editors independently decide which of those stories will appear on the McClatchyDC Web site. KHN stories also may be distributed to other news organizations.


KHN's editors include Laurie McGinley, the executive editor for news, who spent 27 years at the Wall Street Journal; Peggy Girshman, executive editor for online, who was a former managing editor of National Public Radio and former executive editor at Congressional Quarterly, and John Fairhall, senior editor, who was a reporter and editor at the Baltimore Sun for 27 years.


Read more about KHN, its staff and its advisory board here.


The Kaiser Family Foundation is a non-profit private foundation that focuses on the major health care issues facing the U.S., as well as the U.S. role in global health policy. It was founded in 1948 by industrialist Henry John Kaiser, whose businesses included Kaiser Aluminum and Kaiser Steel and who created Kaiser Permanente to provide health care for his workers and their families.


After Henry Kaiser died in 1967, his conglomerate broke up, and the Foundation, which had been a beneficiary of the shares, sold its stock, divesting itself completely by 1985. Neither KHN nor the Foundation has any association with Kaiser Permanente or Kaiser Industries. Family members who remained active with the foundation do not hold seats on the board of either Kaiser Permanente or Kaiser Industries.


Read more about the Kaiser Family Foundation here.


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