Consumer

Medicare said it will consider paying doctors to counsel patients about their options for end-of-life care, the same idea that spurred accusations of "death panels" and fanned a political furor around President Barack Obama's health care law five years ago.

The announcement came late last week in a voluminous regulation on physician payment. It will "give the public ample opportunity to weigh in on the topic," said Medicare spokesman Aaron Albright.

Medicare will consider a change for 2016.

Home Health Workers Strive For Pay, Insurance

Nov 4, 2014

Holly Dawson believes her job is a calling.

She is one of about 2 million home care workers in the country. The jobs come with long hours and low pay.

Each workday, Dawson drives through the Cleveland suburbs to help people take their medicines, bathe and do the dishes. She also takes time to lend a sympathetic ear.

Top medical experts studying the spread of Ebola say the public should expect more cases to emerge in the United States by year's end as infected people arrive here from West Africa, including American doctors and nurses returning from the hot zone and people fleeing from the deadly disease.

But how many cases?

Call it drugs for the departed: A quirky bureaucratic rule led Medicare's prescription drug program to pay for costly medications even after the patients were dead.

That head-scratching policy is now getting a second look.

A report released Friday by the Health and Human Services Department's inspector general said the Medicare rule allows payment for prescriptions filled up to 32 days after a patient's death — at odds with the program's basic principles, not to mention common sense.

The U.S. health care apparatus is so unprepared and short on resources to deal with the deadly Ebola virus that even small clusters of cases could overwhelm parts of the system, according to an Associated Press review of readiness at hospitals and other components of the emergency medical network.

Experts broadly agree that a widespread outbreak across the country is extremely unlikely, but they also concur that it is impossible to predict with certainty, since previous Ebola epidemics have been confined to remote areas of Africa.

Sickest Patients to Get Pricey Hep C Drugs

Oct 29, 2014

In the past year, new hepatitis C drugs that promise higher cure rates and fewer side effects have given hope to millions who are living with the disease.

But many patients whose livers aren’t yet significantly damaged by the viral infection face a vexing reality: They’re not sick enough to qualify for the drugs that could prevent them from getting sicker.

J. Scott Applewhite / Associated Press

For Americans wondering why President Barack Obama hasn’t forced all states to follow a single, national rule for isolating potential Ebola patients, the White House has a quick retort: Talk to the Founding Fathers.

State leaders in New York and New Jersey are at odds with scientists over Ebola as the states' governors back 21-day quarantines for medical workers returning from West Africa, while the nation's top infectious-disease expert warns that such restrictions are unnecessary and could discourage volunteers from aiding disease-ravaged countries.

University of Texas at Arlington

The health care worker who was quarantined at a New Jersey hospital because she had contact with Ebola patients in West Africa is sharply criticizing the way her case has been handled.

Kaci Hickox, the first traveler quarantined under Ebola watches in New Jersey and New York, gave a first-person account to the Dallas Morning News, which was posted on the paper's website Saturday.

More Plans Opt for Spending Limits

Oct 21, 2014

Aiming to contain health care costs, a growing number of employers and insurers are adopting a strategy that limits how much they’ll pay for certain medical services such as knee replacements, lab tests and complex imaging.

A recent study found that savings from such moves may be modest, however, and some experts question whether “reference pricing,” as it’s called, is good for consumers.

Medical marijuana supporters have had a singular focus in making their case to voters across Florida: sick and suffering patients.

Many backers also see the money at stake in the debate over Amendment 2.

Thousands have attended workshops about how to start marijuana businesses. Farmland filled with tomatoes, lettuce and cucumbers awaits the possibility of being replanted with a new leafy green. And entrepreneurs ready to offer everything from legal services to cannabis-infused chocolate-covered pretzels stand by for a chance to expand into the fourth-largest state.

HealthCare.gov, the website for health insurance under President Barack Obama’s health care law, has been revamped as its second enrollment season approaches. But things are still complicated, since other major provisions of the Affordable Care Act are taking effect for the first time. A look at website and program changes just ahead:

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Old: 76 online screens to muddle through in insurance application.

Employer Plans: Premiums, Consumer Costs Hike

Oct 14, 2014

Fall is enrollment season for many people who get insurance through their workplace. Premium increases for 2015 plans are expected to be modest on average, but the shift toward higher out-of-pocket costs overall for consumers will continue as employers try to keep a lid on their costs and incorporate health law changes.

Experts anticipate that premiums will rise a modest 4 percent in 2015, on average, slightly higher than last year but lower than typical recent Increases.

“That’s really low,” says Tracy Watts, a senior partner at benefits consultant Mercer.

Got Insurance? You Still May Pay A Steep Price For Prescriptions

Oct 13, 2014

Sandra Grooms recently got a call from her oncologist’s office. The chemotherapy drugs he wanted to use on her metastatic breast cancer were covered by her health plan, with one catch: Her share of the cost would be $976 for each 14-day supply of the two pills.

“I said, ‘I can’t afford it,’” said Grooms, 52, who is insured through her job as a general manager at a janitorial supply company in Augusta, Ga. “I was very upset.”

Long-Acting Contraceptives Still Often Not Free For Women

Oct 13, 2014

New research suggests that teenagers are more likely to choose long-acting contraceptives when cost is removed from the equation. And free coverage of such methods is required by the health law. But now, a study has found that free coverage of such methods too often still falls short.

The study, published in the journal Contraception by the Guttmacher Institute, found that insurance coverage of contraceptives without cost sharing has improved markedly since the health law’s requirement became effective for most women in 2013.

The Medicare “Part B” premium that most older people pay for outpatient care will stay the same in 2015 — $104.90 a month.

The government says it’s the third consecutive year that the basic monthly premium has held steady.

Higher premiums paid by upper-income beneficiaries also are unchanged. These are for people with an income greater than $85,000 a year, or $170,000 for married couples.

In the 1950s, four people — the founder of the birth control movement, a controversial scientist, a Catholic obstetrician and a wealthy feminist — got together to create a revolutionary little pill the world had never seen before.

They were sneaky about what they were doing — skirting the law, lying to women about the tests they performed and fibbing to the public about their motivations.

Although April 15 seems a long way off, decisions people make about health coverage can have have big tax implications.

I understand that different members of a family can buy different marketplace plans. How does that work with premium tax credits for a husband and wife? How do they get divvied up, and how do we report that to the IRS?

Hospitals have been on the lookout for the Ebola virus in the United States, and Texas Health Presbyterian in Dallas was no exception. A nurse there did ask about the travel history of the patient who later turned out to be infected with the virus. But some members of the medical team didn't hear that the man had recently been in West Africa. So he was initially sent home — even though he was experiencing symptoms of Ebola, and that meant he was contagious.

Exactly one year ago, the Obamacare insurance exchanges stumbled into existence. Consumers struggled to sign up for its online marketplace — and the Obama administration was pummeled. Eventually, HealthCare.gov's problems were mostly fixed, and two weeks ago, the administration announced 7.3 million people have bought insurance through it so far this year.

So, was the health exchanges' first year a success — or something less?

Ask President Obama, and he says you measure the Affordable Care Act's success this way:

You wake up feeling gross – stuffy and full of aches. A quick Google search of your symptoms confirms that yes, you probably have a cold and not the plague. But what if you were directed to a site that had a legitimate sounding name but wasn't really accurate at all?

It sounds like a problem from the ancient days of the Internet. Since then people have learned that .gov leads to bona fide government sites, but .com could be anyone selling you anything.

Lance Shnider is confident Obamacare regulators knew exactly what they were doing when they created an online calculator that gives a green light to new employer coverage without hospital benefits.

"There's not a glitch in this system," said Shnider, president of Voluntary Benefits Agency, an Ohio firm working with some 100 employers to implement such plans. "This is the way the calculator was designed."

Timothy Jost is pretty sure the whole thing was a mistake.

The number of uninsured patients admitted to hospitals has dropped markedly this year, reducing charity care and bad debt cases, particularly in states that have expanded Medicaid coverage under the new federal health care law, a government report released Wednesday concluded.

The report from the Department of Health and Human Services said hospitals in states that have taken advantage of new Medicaid eligibility levels have seen uninsured admissions fall by about 30 percent. Florida is not one of those states.

For Autistic Adults, Options Scarce

Sep 23, 2014

It’s getting easier for parents of young children with autism to get insurers to cover a pricey treatment called applied behavioral analysis. Once kids turn 21, however, it’s a different ballgame entirely.

Many states have mandates that require insurers to cover this therapy, but they typically have age caps ranging from 17 to 21, says Katie Keith, research director at the Trimpa Group, a consulting firm that works with autism advocacy groups.

HealthCare.gov

The government’s own watchdogs tried to hack into HealthCare.gov earlier this year and found what they termed a critical vulnerability — but also came away with respect for some of the health insurance site’s security features.

Those are among the conclusions of a report being released Tuesday by the Health and Human Services Department inspector general, who focuses on health care fraud.

Dying in US Harder Than Needed: Report

Sep 18, 2014

It is time for conversations about death to become a part of life.

That is one of the themes of a 500-page report, titled "Dying In America," released Wednesday by the Institute of Medicine. 

CHIP Future Unclear Under Health Law

Sep 18, 2014

The Children’s Health Insurance Program, a joint federal-state program known as CHIP, has helped cut in half the number of uninsured children since being enacted less than two decades ago, but its future is in doubt due to limited funding in the federal health law of 2010.  A year from now, CHIP will run out of money.  Some advocates for the program want the federal government to finance CHIP for another four years, while other experts have suggested two would suffice.  The Senate Finance Committee’s Subcommittee on Health Care will hold a hearing on the issue Tuesday.

A feathery afternoon rain sweeps across the tall grass and clusters of oak forest here, adding an extra layer of hush to this wilderness preserve that's also a resting place for the dead.

The 75 or so individuals buried at Prairie Creek Conservation Cemetery have one distinction in common: They or their families cared enough about Florida's environment to consecrate their bodies to a natural cycle that will keep these 78 acres and their surroundings free of development and manufactured chemicals for as long as human law can protect them.

Potential complications await consumers as President Barack Obama's health care law approaches its second open enrollment season, just two months away.

Don't expect a repeat of last year's website meltdown, but the new sign-up period could expose underlying problems with the law itself that are less easily fixed than a computer system.

Getting those who signed up this year enrolled again for 2015 won't be as easy as it might seem. And the law's interaction between insurance and taxes looks like a sure-fire formula for confusion.

For example:

President Barack Obama's health care law uses the tax system to subsidize coverage for the uninsured.

Promoting social policy goals through the tax code is a time-honored strategy for both political parties.

For example, the nation's main anti-poverty program, the Earned Income Tax Credit, uses the tax system to supplement the earnings of low-income families.

But melding insurance and taxes — two of the most complicated topics for consumers — won't be easy. Here are some pros and cons:

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