Open season: Health insurance shoppers have until Dec. 16 to check out ACA exchange

November 7, 2019, Daily Journal, Michaela Gibson Morris - Getting sick or injured without health insurance can break anybody’s bank. Through Dec. 15, folks without access to employer-based health insurance or Medicare can shop the federal health care exchange created by the Affordable Care Act, commonly called Obamacare. “People assume I can’t afford it or it’s not a good plan, but that’s not true,” said Veronica Bell of Tupelo-based Bell Associates, which is certified to serve as a broker for the exchange. “We’ve gotten good reports all around.” Most people can shop on the exchange; you have to be a U.S. citizen or legal resident. The federal marketplace is the only venue where Mississippi insurance shoppers can access income-based subsidies and use tax credits to pay for premiums if they fall between 100 and 400 percent of the federal poverty level. For a family of four, that would range from $25,100 to $100,400.

The Air Ambulance Billed More Than His Surgeon Did For A Lung Transplant

November 6, 2019, KHN, Anna Almendrala - Before his double lung transplant, Tom Saputo thought he had anticipated every possible outcome. But after the surgery, he wasn’t prepared for the price of the 27-mile air ambulance flight to UCLA Medical Center - which cost more than the lifesaving operation itself. “When you look at the bills side by side, and you see that the helicopter costs more than the surgeon who does the lung transplant, it’s ridiculous,” said Dana Saputo, Tom’s wife. “I don’t think anybody would believe me if I said that and didn’t show them the evidence.” “Balance billing,” better known as surprise billing, occurs when a patient receives care from a medical provider outside of his insurance plan’s network, and then the provider bills the patient for the amount insurance didn’t cover. These bills can soar into the tens of thousands of dollars.

Bridging The Gap In Rural Health Access

November 7, 2019, Health Affairs Blog, Robert Brodell - Nearly 78 million people live in the 7,500-plus areas designated as primary care health professional shortage areas by the Department of Health and Human Services (as of November 2019). Approximately 65 percent of these shortage areas are in rural parts of the country. Patients in need of dermatologic care are among those affected by these shortages, and the implications can be severe for patients with skin diseases-many of which are serious and can be life threatening. More than 25 percent of the US population sought treatment for at least one skin disease in 2013, according to data from the American Academy of Dermatology’s Burden of Skin Disease report.

Miss. forfeits $1 million daily in Medicaid funds. Could the money help the 77,000 uninsured citizen

November 5, Mississippi Today, Mississippi Center for Investigative Reporting, Shirley L. Smith - By resisting Medicaid expansion, Mississippi is forfeiting more than $1 million a day that could help thousands of uninsured people with untreated mental illnesses and health care providers drowning in uncompensated costs, said state Sen. Hob Bryan, vice chairman of the Senate Medicaid Committee. “Medicaid expansion is not going to solve the problem with mental health service delivery that we have in the state, but it would help,” said Bryan, D-Amory. “More people would be able to get services because they would have some ability to pay for them, and they would be able to get services more quickly before they are in terrible shape.” Renewed discussions about expanding Medicaid are coming at a time when a federal court ruling in September slammed the state for over-institutionalizing people with mental illness by failing to provide adequate community-based services.

Medicaid expansion reduced preventable hospitalizations

November 4, 2019, Modern Healthcare, Harris Meyer - With political battles continuing over Medicaid expansion, a new study found states that expanded Medicaid saw greater reductions than non-expansion states in hospital admissions, length of stay and hospital costs for conditions that can be managed with ambulatory care. States that expanded coverage to low-income adults under the Affordable Care Act saw a 3.5% reduction in annual “ambulatory-care sensitive” condition discharge rates, and a 3.1% drop in inpatient days in 2014 and 2015, according to the study published Monday in Health Affairs. Hospital costs dipped by nearly 3%. The decline in discharge rates in expansion states was concentrated among chronic respiratory conditions, diabetes-related complications, and bacterial pneumonia.

Families fight insurers for life-saving care for loved ones with mental health conditions

October 22, 2019, CBS News, Staff - Every year, an estimated 1 in 5 American adults experiences mental illness. When it comes to insurance coverage, the law is clear. The federal Mental Health Parity legislation passed in 2008 requires health insurers to provide at least equal coverage for mental health conditions, as they do for medical and surgical care. But as CBS News’ Dr. Jon LaPook found out, some families still have to fight to get the life-saving care their loved ones need. In 2013, Brian Cada’s 15-year-old daughter Nicole took her own life. A year and a half later, his younger attempted suicide. She was 14.  “She was unable to really process the death of her sister. She kept it inside,” Cada said. Residential treatment was denied. A less intensive level of care was approved.  “The hospital ... said what that translates to is your daughter has not failed often enough to get a longer-term treatment center,” Cada said.