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News Archives

Many Insured Children Lack Essential Health Care, Study Finds

November 20, 2016, The New York Times, Marc Santora- Margo Solomon has health insurance for herself and her four children. But actually getting treatment is another matter. Ms. Solomon, a 35-year-old mother from the Bronx, says she has struggled to find a doctor who accepts her insurance. And with three of her children coping with asthma, and one with more complicated medical problems, locating a specialist is even more challenging. And once in the door, she cannot afford the costs, including for deductibles and medications. “I feel like I am all alone out here,” Ms. Solomon said.
She is not alone. A new study to be released on Monday by the Children’s Health Fund, a nonprofit based in New York City that expands access to health care for disadvantaged children, found that one in four children in the United States did not have access to essential health care, though a record number of young people now have health insurance.

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Uncertain Fate Of Health Law Giving Health Industry Heartburn

November 21, 2016, Kaiser Health News, Julie Rovner and Chad Terhune- Six years into building its business around the Affordable Care Act, the nation’s $3 trillion health care industry may be losing that political playbook. Industry leaders, like many voters, were stunned by the election of Donald Trump and unprepared for Republicans’ plans to “repeal and replace” Obamacare. In addition, Trump’s vague and sometimes conflicting statements on health policy have left industry officials guessing as to the details of any substitute for the federal health law. “It will be repealed and replaced,” Trump said Sunday in an interview on CBS’ “60 Minutes.” At the same time, he vowed to preserve popular provisions of the law like ensuring that people with preexisting conditions can get insurance and allowing young adults to stay on their parents’ health plans.

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NMHS, United seek solution, finding little agreement

November 20, 2016, Daily Journal, Michaela Morris- Leaders at both North Mississippi Health Services and United Healthcare are hoping they can resolve a payment dispute. However, they have different views of the facts that could leave more than 50,000 United Healthcare subscribers out of network for North Mississippi Medical Center hospitals and clinics in 2017. North Mississippi Health Services has signaled it is terminating its provider agreements with United Healthcare because of breach of contract unless a resolution can be found. “We’re preparing for (NMMC-Tupelo) to be out of network on Dec. 29,” said Shane Spees, NMHS president and chief executive officer. United Healthcare holds that the claims have been paid appropriately and that NMMC-Tupelo should remain in the provider network through May 2017 when the contract expires.

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How Trump’s Health Reform Could Affect Mississippi

November 16, 2016, Jackson Free Press, Arielle Dreher- Lower and middle-class Mississippians could have the most to lose from Trump’s proposed health-care reforms, including those who benefit from insurance plans through the Affordable Care Act marketplace as well as those who qualify for Medicaid. Re-enrollment for marketplace insurance plans was underway before the presidential election, and Roy Mitchell, executive director at the Mississippi Health Advocacy Program, said enrollment spiked the day after the election. “I think they had one of the highest days (of enrollment) ever; there is a lot of concern-we’ve had calls from people concerned about their existing coverage and viability,” Mitchell told the Jackson Free Press. “We are trying to reassure people that as it stands now, the comprehensive health coverage is still available through 2017.”

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HealthCare.gov Sees Early Rise in Enrollment Amid Worries on Law’s Future

November 16, 2016, The New York Times, Robert Pear- More than a million people have signed up for 2017 health insurance coverage on HealthCare.gov, and more than 300,000 of them selected plans in the three days after Donald J. Trump won the presidential election, the Obama administration said on Wednesday. About one-fourth of those using the online exchange to sign up - 246,400 people - were new to the federal marketplace, and the other 761,800 were renewing coverage they had this year. The data covered plan selections from Nov. 1, the first day of the fourth annual open enrollment period, to Nov. 12, for the 39 states that use the health care website. Federal officials said the total was 53,000 more than the number of selections in the first 12 days of the enrollment season last year.

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Surprise! Insurance Paid the E.R. but Not the Doctor

November 16, 2016, The New York Times, Margot Sanger-Katz and Reed Abelson- Doug Moore was out of town at a Florida conference on information technology in October 2015 when he was struck with terrible abdominal pain. He tried to go to an urgent care center and called several local doctors. No one could see him. So he headed to the nearest emergency room. On the way, he called his insurance company to make sure the visit would be covered. Once he got to the Palms of Pasadena Hospital emergency room, a doctor gave him some medication and tests, and let him go. A month later, feeling better and back at home in Baton Rouge, La., Mr. Moore, 34, received an out-of-network bill from the doctor who treated him - for $1,620. “That really makes me mad, and kind of breaks my heart,” he said.

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Surprise Medical Bills Found in 22 Percent of ER Visits

November 16, 2016, NBC News, Maggie Fox and Jane Derenowski- Tracey and Inga Davis had tried hard to do the right thing. When Tracey broke his ankle in August, he and his wife checked to make sure that the hospital emergency room he was taken to was within their health insurance network and that services would be covered. They did their homework. Yet they got slapped with a bill for more than $700, because the emergency room physician who treated Tracey wasn’t in their insurance network. They are not alone. A new study published in the New England Journal of Medicine finds that, across the country, 22 percent of people visiting in-network emergency rooms have to deal with bills from out-of-network doctors.

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Inside the fight to save Obamacare: how one longtime advocate plans to fight repeal

November 15, 2016, VOX, Sarah Kliff- Last summer, Obamacare’s future seemingly secure, longtime health advocate Ron Pollack announced he would retire in March 2017. “I had expected to move on to something else, and I was looking forward to that,” Pollack says. The election changed all that. Pollack has spent decades fighting for the expansion of health coverage in the United States. He is the executive director of Families USA, one of the key advocacy groups that helped pass the Affordable Care Act. He then helped found another group, Enroll America, which has led efforts to get people signed up for coverage under the new law.

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Expect Medicaid to Change, but Not Shrivel, Under Donald Trump

November 15, 2016, The New York Times, Robert Pear- Negotiations over a proposed Medicaid block grant would need to answer difficult questions: How is the amount of the initial federal allotment determined? Will this amount be adjusted to reflect population growth, the effect of an economic downturn, or increases in the cost of medical care or in consumer prices generally? Will it be adjusted to reflect the advent of costly but effective drugs like those to treat hepatitis C? Will states have to continue spending their own money on Medicaid? Will Medicaid beneficiaries still have a legally enforceable right - an entitlement - to coverage and care if they meet eligibility criteria set by the federal government and states?

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Despite election results, Obamacare expected to stick for 2017

November 13, 2016, Daily Journal, Michaela Morris- Among the related proposals under consideration will be funding Medicaid through a block grant program, where the federal government would give the states a set amount of money to provide health services for the poor. In Mississippi, Medicaid covers poor children, pregnant women and the disabled. Most of the people on Medicaid in Mississippi are children, but most of the expense comes from covering long-term care for the impoverished in nursing homes. “I think it’s something to look at,” Wicker said. The block grant approach would be troublesome for Mississippi, Mitchell said.“With block granting Mississippi legislators will be forced to find ways to reduce payments to providers, cover fewer services and cut people from the current program,” Mitchell said.

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