News

Texas removes thousands of children from Medicaid each month due to red tape, records show

April 22, 2019, The Texas Tribune, Elizabeth Byrne - Katherine Edmundson didn’t know her 7-year-old son was off Medicaid until she took him to the dentist for his annual cleaning in February. An employee at the front desk told her that his coverage was invalid and that her son couldn’t be seen that day. “At that time, he was already needing to be seen,” said Edmundson, a receptionist at a public school in Edinburg. “I was going to be charged over $100 just for a cleaning and it was time for him to have X-rays done.” After leaving the dentist with her son’s teeth still in need of a cleaning, Edmundson said she went home and immediately started another Medicaid application. She said she doesn’t remember receiving any notice from the state’s Health and Human Service Commission that her son lost coverage and her income hadn’t changed since it was last renewed. Commission spokeswoman Carrie Williams said confidentiality laws prevented her from discussing individual cases. The struggles of parents like Edmundson are why some state legislators are calling for a change in the renewal process of children’s Medicaid in Texas.


Republicans Offer Health Care Bills to Protect Patients (and Themselves)

April 20, 2019, The New York Times, Robert Pear - Sarah Lueck, a health policy analyst at the liberal-leaning Center on Budget and Policy Priorities, saw another potential problem in the Senate bill. Even if a person with cancer could buy insurance without being charged a higher premium, she said, “his or her benefits could run out because the insurer imposes an annual or lifetime limit.” Republicans say they want to work with Democrats on the issue. Representative Tom Reed of New York, for example, said that Democrats should just “take yes for an answer” because Republicans agree with them on the need to protect people with pre-existing conditions. “We heard the voice and the fear that was the result of the 2018 election, where this issue became a centerpiece in that vernacular and in that debate,” Mr. Reed said. “Pre-existing condition protections will remain the law of the land.”


Faulty state renewal processes blamed for Medicaid coverage declines

April 19, 2019, Modern Healthcare, Harris Meyer - Burdensome state eligibility redetermination processes have pushed down Medicaid enrollment in a number of states, raising questions about whether eligible adults and children are being wrongly dropped from coverage, according to a new report. Enrollment in Medicaid and the Children’s Health Insurance Program dipped last year by about 1.6 million, including 744,000 children, according to the report by the liberal advocacy group Families USA. It fell most sharply in states like Tennessee, Arkansas and Missouri, which have established tougher new eligibility redetermination processes. Those three states saw declines of 9.7%, 7.3% and 7.2%, respectively.


CBO: over 1 million Americans have become uninsured since 2016

April 19, 2019, Vox, Sarah Kliff - More than 1 million Americans have lost health coverage since 2016, a new report from the Congressional Budget Office finds. The report - which came out within hours of the Mueller report on Thursday and so didn’t get much attention - follows other studies, all suggesting that America’s uninsured rate is rising under President Trump, whose administration has passed new rules that make it more difficult to enroll in coverage. The CBO estimates that the number of Americans without insurance has risen from 27.5 million in 2016 to 28.9 million in 2018, an increase of 1.4 million Americans going uninsured. Much of that increase is concentrated in the Medicaid program, where the Trump administration has approved new rules like work requirements that can make it more difficult for low-income Americans to enroll in the program.


TennCare, under fire for dropping children, gains 24,000 kids in February and March

April 17, 2019, Tennessean, Brett Kelman- More than 24,000 children joined TennCare in the past two months, partially reversing a two-year purge of kids from state insurance programs that has worried families, doctors and lawmakers alike. TennCare officials also insisted Tuesday they did not cut children without alerting their parents, despite acknowledging that they’ve used an outdated, “rudimentary” system to process applications and renewals for years. TennCare enrollment data posted online late last week shows that nearly 22,000 kids enrolled in the program in February and another 2,500 kids enrolled in March. This new data replaces older state data showing 52,000 children were cut from TennCare in February. Those figures were later taken offline after officials said they were incorrect.


Family hit with $3,700 bill for out-of-network anesthesiologist

April 17, 2019, CBS News, Jim Axelrod - A growing number of states are passing laws to protect patients from surprise medical bills. Fifty-seven percent of Americans have been hit with a bill they thought would be covered by insurance and 20 percent of those bills were from doctors outside their insurance networks. It was pure bliss for Adam and Laura Parkinson when their son, Nathan, arrived 13 months ago. Then within days came a second delivery. They received a surprise medical bill for $3,700. “For a doctor that we’ve seen for five minutes to give us a bill like this. It was crazy,” said Adam Parkinson. They’d done their homework, choosing an in-network hospital and obstetrician to avoid any surprises. But the anesthesiologist, who administered an epidural for Laura was out-of-network. After an appeal, insurance paid a portion. But the Parkinsons were on the hook for nearly $1,500.  “You go to a hospital expecting it to be in network. You don’t have to ask a question of every single person who walks in the door, hold on are you in-network,” Adam said.