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After running out of cancer medication, hospital delayed care, refused to pay $42K bill

June 7, 2018, The Clarion-Ledger, Anna Wolfe- Gus Mohamed, a nurse in St. Dominic’s emergency department, got his last dose of chemotherapy in April, putting him in remission. “It was supposed to be one of the happiest days of my life,” he said. Instead, he was trying to figure out what to do about his $42,036 medical bill. His insurer, the hospital, had denied payment for one of his six doses of treatment for Non-Hodgkin lymphoma.  St. Dominic’s pharmacy had run out of the medication and even though Mohamed’s own doctor had the drugs in stock, the hospital wanted Mohamed to wait until it got a new shipment. So when he disobeyed, it stuck him with the bill. Since the Clarion Ledger’s interviews with Mohamed, his doctor and the hospital, the hospital began processing payment on the bill - but not before delaying patient care.

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A ‘Sick Joke’: Democrats Attack Health Secretary on Pre-existing Conditions

June 12, 2018, The New York Times, Robert Pear- Democratic senators blistered President Trump’s health secretary on Tuesday, telling him that the Trump administration’s efforts to undo health insurance protections for people with pre-existing conditions made a mockery of the president’s campaign to rein in prescription drug prices. The secretary of health and human services, Alex M. Azar II, told Congress that he would be glad to work with lawmakers on legislation - “alternatives to the Affordable Care Act, modifications of the Affordable Care Act” - to provide access to insurance for people with pre-existing conditions. The decision regarding pre-existing conditions is “a constitutional and legal position, not a policy position,” Mr. Azar told the committee.

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McConnell: ‘Everybody’ in Senate likes pre-existing condition safeguards

June 12, 2018, Politico, Jennifer Haberkorn- Senate Majority Leader Mitch McConnell said “everybody” in the Senate wants to preserve consumer protections for people with pre-existing conditions, an Obamacare provision that the Trump administration last week said is unconstitutional and should be struck down in court.“Everybody I know in the Senate everybody is in favor of maintaining coverage for pre-existing conditions,” McConnell told reporters in the Capitol. “

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The New Obamacare Lawsuit Could Undo Far More Than Protections for Pre-existing Conditions

June 12, 2018, The New York Times, Margot Sanger-Katz- A new Trump administration court challenge is explicitly aiming to remove a central promise of Obamacare - its protections for people with pre-existing health conditions. But it could also make it much harder for any individual to obtain health insurance on the open market. The administration’s brief, filed in Federal District Court in Texas on Thursday, focuses on the core Obamacare provisions that make insurance available to people with prior illnesses. Those protections - which President Trump once praised and Republicans in Congress vowed not to disrupt last year - don’t exist in a vacuum. Undoing them could also undo other programs in the health law, making insurance harder to obtain for people who buy their own insurance or get it through a small company, and possibly making it unaffordable for many middle-income people who receive financial assistance with their health insurance premiums under the law.

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Out-of-network air ambulance gouges stroke patient, then asks for non-disclosure

June 13, 2018, The Clarion-Ledger, Anna Wolfe- Jack Wayne had a stroke and couldn’t talk when medical professionals loaded him onto a chopper at Forrest GeneralHospital in Hattiesburg. He was airlifted to University of Mississippi Medical Center, where he said he received great care, followed by a full recovery. When he finally negotiated his bill down to nearly $17,000 the private air ambulance company Med-Trans asked Wayne to sign and return a letter agreeing to keep his “discount” secret. “I was pretty disgusted,” he said. He didn’t sign. “That is one of the most unfair situations,” Roy Mitchell, director of the Mississippi Health Advocacy Program, said of Wayne’s case. Mitchell said there are two kinds of out-of-network ambulance scenarios: transportation from the scene of an accident to a hospital and transfers from one hospital to another.“That situation he (Wayne) was in is one of the worst and probably one of the most ripe for abuse - the air ambulance from hospital to hospital,” Mitchell said. “It’s just a feeding ground for predatory billing practices.”

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5 Things To Know About Medicaid Work Requirements

June 14, 2018, The Washington Post, Phil Galewitz, Kaiser Health News- The Trump administration’s decision in January to give states the power to impose work requirements on Medicaid enrollees faces a federal court hearing Friday. The lawsuit before the U.S. District Court in Washington, D.C., will determine whether tens of thousands of low-income adults in Kentucky will have to find jobs or volunteer in order to retain their health coverage. But the ruling could have far-reaching implications affecting millions of enrollees nationwide and determining how far the Trump administration can go in changing Medicaid without congressional action. Kentucky was the first of four states, so far, to win federal approval to advance a work requirement. Indiana, Arkansas and New Hampshire are the others. Each is now in the early stages of implementation.

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Insurance experts: ObamaCare mandate repeal driving premium increases

June 13, 2018, The Hill, Jessie Hellmann- Increases in health-care costs and policy changes are driving ObamaCare premium increases for the 2019 plan year, according to a new report released Wednesday. The American Academy of Actuaries says that the elimination of the individual mandate penalty and the expansion of cheaper health plans with fewer benefits will contribute to premium increases next year. Several insurers seeking rate increases for next year have cited the repeal of the mandate penalty as a primary reason for the request. “Eliminating the penalty is expected to increase premiums as unsubsidized lower-cost healthy individuals will be more likely to forgo coverage,” the brief says. The Trump administration is expected to roll out changes this summer that would expand access to short-term, limited-duration plans and association health plans.

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You might not have to pay that medical bill. Here’s the law you need to know.

June 15, 2018, The Clarion-Ledger, Anna Wolfe- You might not be obligated to pay that sky-high medical bill. That’s because of a 5-year-old Mississippi law almost no one seems to know about. Some large medical bills arise when a patient’s insurance company doesn’t pay the entire billed charges, so the health care provider bills the patient for the balance. This is typical when a patient receives services from a provider they weren’t aware was out-of-network. For example, Anesthesiologists often bill separately from other providers, such as hospitals, and are sometimes not included in an insurer’s network, leading to a surprise bill. What you should do if you think you’ve received a balance bill? Call the Mississippi Health Advocacy Program at 601-353-0845.

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Key takeaways from lawsuit against Kentucky’s Medicaid work requirements

June 15, 2018, The Hill, Nathaniel Weixel- Attorneys for the Department of Health and Human Services (HHS), as well as Kentucky Gov. Matt Bevin (R), began their legal fight Friday against a group of activists from the state who are suing the Trump administration over the approval of Kentucky’s Medicaid waiver. Bevin has repeatedly said the state’s Medicaid expansion under ObamaCare is not fiscally sustainable, and that the waiver is needed to bring down the costs of covering so many new individuals. Kentucky was the first state in the country to win permission from the Trump administration to impose conservative Medicaid regulations. The waiver, which allows the state to institute work requirements, premiums and other conservative changes to Medicaid, takes effect on July 1, only two weeks away. The activists’ lawsuit seeks to overturn the waiver entirely. Here are the main takeaways from oral arguments:

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Administration Challenges ACA’s Preexisting Conditions Protection In Court

June 8, 2018, Kaiser Health News, Julie Rovner and Julie Appleby- The Trump administration is refusing to defend key parts of the Affordable Care Act, essentially arguing that federal courts should find the health law’s protection for people with preexisting conditions unconstitutional. The federal lawsuit hinges on the ACA’s individual mandate, or the requirement to get health coverage or pay a penalty. The mandate has long been a sticking point for conservatives, who argue that the government should not be telling individuals what coverage they must have. But that mandate was crucial to persuading insurers to offer plans under the ACA. It helped expand their risk pools while the law forced them to guarantee coverage to any customer. Insurers were not allowed to raise costs for people with preexisting conditions. The administration’s brief, filed Thursday in federal district court in Fort Worth, Texas, takes aim at those link

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