health insurance

With less than a dozen days left in power, the Trump administration on Friday approved a radically different Medicaid financing system in Tennessee. With this move, the federal government is for the first time granting a state broader authority in the operation of its health insurance program for the poor without interference from Washington, allowing Tennessee to make decisions on such issues as whether to add new benefits or eligibility categories or spend Medicaid dollars outside of health care, if it thinks that would help enrollees.

CDC/Unsplash

With the Supreme Court hearing oral arguments Tuesday about the future of the Affordable Care Act, the upcoming decision will have a major impact on the health of Kentuckians. 

Kentucky ranks 3rd in the nation for the number of adults with high cholesterol, 4th in the number of obese children, and 6th in the number of obese adults.

The state ranks 7th in the number of adults with Type 2 diabetes.

Those are among the findings in the report 2020s Most Overweight and Obese States in America by the personal finance website WalletHub. 


Updated at 4:35 p.m.

The Supreme Court, with a newly constituted and far more conservative majority, took another look at Obamacare on Tuesday. But at the end of the day, even with three Trump appointees, the Affordable Care Act looked as though it may well survive.

To many, it may have seemed like déjà vu.

President Trump has tried to get rid of the Affordable Care Act since the first day of his presidency, but there's one part of Obamacare that he wants to preserve.

"We will always protect patients with preexisting conditions — always," Trump told a campaign crowd on Sunday in Londonderry, N.H. It's a message he has shared repeatedly in the final days and weeks before the presidential election.

Alexandra Kanik

When the Senate Judiciary Committee voted Thursday to move forward with President Donald Trump’s Supreme Court Justice nominee Amy Coney Barrett, Senate Democrats boycotted. In their places stood poster-sized photos of people the senators said would lose health care coverage if the court strikes down the Affordable Care Act. 

With just a little more than a week before Election Day and with a challenge to the health care law coming before the high court, health care is on both the ballot and the docket. And for the Ohio Valley — a region with some of the nation’s worst health outcomes — the stakes are high.    

“I mean people would lose their lives as a result of it,” said Ben Chandler, CEO of the Foundation for a Healthy Kentucky, a nonpartisan research and advocacy group. “I’m personally familiar with a number of people here, right here in Kentucky, who would not be alive today but for the Affordable Care Act.”

J. Tyler Franklin

Democratic Gov. Andy Beshear announced on Wednesday that Kentucky will transition back to a state-based health insurance exchange, known as Kynect.

In 2017, Republican Gov. Matt Bevin dismantled Kynect, and Kentuckians had to start purchasing health coverage on the federal exchange instead. That federal program comes with about a 3% user fee, which Beshear said cost people in Kentucky $9.8 million in 2018.

“In the last four years we moved backwards on health care,” Beshear said. “We’ve been paying more, over the last four years, to get less.”

WKYU

There’s a saying credited to TV therapist Dr. Phil that borders on cliché.

It goes: “Life’s a marathon, not a sprint”, meaning obstacles are inevitable, it’s going to exhaust the hell out of you, and you’ve got to keep fighting anyway.

It applies to mental health too, making support networks crucial.


Flickr/Creative Commons/401(K) 2012

A new Pew Charitable Trusts report shows Kentucky’s spending on Medicaid has increased since the recession, but remains below the national average. The study looked at how much Medicaid spending takes up of each state’s revenue.

 

Pew found Medicaid consumed a greater portion of state revenue across the country from 2000 to 2017. Justin Theal, with Pew, said the organization studies the issue for a couple of reasons.


Screenshot from Gov. Andy Beshear Facebook

Governor Andy Beshear will not move forward with former Governor Matt Bevin’s controversial changes to Kentucky’s Medicaid program. Beshear made the announcement Monday, within his first week in office.

Beshear said he’s sending a letter to federal officials to rescind the 1115 waiver that Bevin first submitted back in 2016. He also signed an executive order repealing Bevin’s signature health policy.

“Let me be clear, this Medicaid waiver would have cost Kentucky money, lives and jobs: I believe it would have saved us nothing,” Beshear said. “By every measure, Kentucky’s decision to expand Medicaid in 2014 has been a huge success.”


NPR

A little under a half a million Medicaid enrollees in Kentucky may be confused about what recent news about the state’s Medicaid contracts means for their health benefits. About 435,130 Kentuckians currently have Medicaid health insurance through Passport and Anthem, both of which recently lost out on contract renewals.

The companies are still offering coverage now, and people are able to sign up for a plan from either during open enrollment, which ends December 13. But as the situation stands, these two plans won’t offer Medicaid benefits starting July 1; Molina and United Healthcare will take their places. And all that could change depending on decisions by new Gov. Andy Beshear’s administration or the success of the companies’ appeals. 

Flickr/Creative Commons

Anthem Kentucky has submitted its appeal to the state protesting its exclusion from the Medicaid contracts issued two weeks ago by former Governor Matt Bevin’s administration. Anthem is asking for Governor Andy Beshear’s new administration to halt the new contracts and reconsider.

About two weeks ago, former Gov. Matt Bevin’s administration issued contracts to five insurance companies that will administer Medicaid benefits in the state starting in July; Anthem Kentucky and Passport Health weren’t among them. Meanwhile, United Healthcare and Molina were granted contracts to offer the benefits starting in July.


Tennessee Health Care Campaign Facebook page

A key health care advocacy group in the state is reinventing itself amid federal funding cuts. After losing a grant to hire Obamacare insurance navigators, the Tennessee Health Care Campaign has decided to just start selling plans itself.

The Affordable Care Act included funding to have so-called navigators help people sort through all of the newly available insurance plans. But the Trump administration slashed that funding.

Instead of competing for what’s left, the Tennessee Health Care Campaign has applied with the state to become a nonprofit insurance broker. Executive director Jacy Warrell says one former navigator has already passed the licensing exam with potentially more to come.

 


U.S. Air Force photo illustration/Tech. Sgt. Mark R. W. Orders-Woempner

It was a Friday afternoon, and a young man — the doctor called him “J” — needed help. J was addicted to heroin. The doctor, Mike Kalfas, had treated him several times before with buprenorphine, a drug that blocks opioid cravings and is part of a class of drugs most successful in keeping patients in recovery.

J had recently gotten out of jail on a drug-related charge, Kalfas said. There, he’d had to stop using buprenorphine because it wasn’t available.

“I wrote him the prescription, and it’s 5:30 p.m. on a Friday when he left my office,” Kalfas told Kentucky lawmakers earlier this month. “About 6:30 p.m. the paper comes over the fax machine, denying his medication.”

Owensboro Health

Owensboro Health Regional Hospital has been working with a third party since August of 2018 to create a dashboard with prices and market comparisons. The hospital is complying with a new federal law requiring hospitals across the country to post prices for stays, procedures, drugs, services and supplies.

“This is an opportunity for us to empower our consumers and patients, to understand more about pricing. And we want to be a very transparent and open organization,” said director of marketing and public relations Brian Hamby.

Kentucky Hospital Association

Most Kentuckians with Medicaid insurance will have to pay a $3 copayment at the doctor starting this week. That’s because of a new state requirement that took effect Jan. 1.

The copays don’t apply to people who are pregnant, children, or people in hospice.

Health providers will ask for copays at each visit, but if a person making under 100 percent of the federal poverty limit doesn’t have the money for the copay, they won’t be turned away. People who make between 101 and 138 percent of the poverty limit could be turned away, or the provider could choose to cover the cost.

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