Category: Health Care Reform

America’s health care system is undergoing many changes – it’s hard for insurance professionals to keep updated let alone consumers. Here we make it easy and publish daily articles on the changes and challenges that health care reform has ahead.

Rogue Agents and Policy Switching – The Hidden Dangers for Consumers and Insurance Brokers

Logan B.
Policy Switching Warning - Health Insurance

Unscrupulous Practices Lead to Stolen Policies and Tax Headaches for Many In an alarming trend across several states, consumers covered by Affordable Care Act insurance plans are finding themselves unwitting players in a dangerous game. Without their knowledge or consent, their health insurance policies are being switched, leaving in their wake potential tax complications and vanished coverage. This epidemic of unsanctioned changes, predominantly observed in Florida, Georgia, and Texas, is stirring both consumer and industry unrest. Government and Industry Responses to Unauthorized Policy Switching and Changes Florida and Texas have…

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Many health insurance plans still won’t cover Wegovy despite new approval

H. Cutner
Health insurance - RX Meds Denied

Even though the drug has received approval for heart wellness use, not just weight loss, it’s frequently not covered. In the United States, Wegovy was previously only approved for use as a weight loss drug and was commonly not covered by health insurance plans.  Now, the headline-making drug has also been approved in the country for heart health, but this isn’t expected to broaden availability for its coverage. The Novo Nordisk drug is taken by injection on a weekly basis As a prescription weight loss drug – one of only…

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Could Substantial Incentives Trigger a Nationwide Expansion of Medicaid?

Loreen
medicaid us affordable care act

In the decade since the Affordable Care Act’s (ACA) inception, a critical coverage gap remains in the health insurance landscape. This gap prevails in the 10 states withholding the ACA Medicaid expansion, affecting 1.5 million uninsured individuals. In this detailed analysis, we investigate who is affected, the potential for expanded coverage, and examine new economic incentives that may prompt a shift towards the adoption of Medicaid expansion in remaining states. Understanding the Health Insurance Coverage Gap The ‘Coverage Gap’ is a situation in some states where adults can’t get Medicaid…

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Virginia considers mandatory health insurance for PANS/PANDAS

H. Cutner
Health insurance - Mandatory in Virginia

The “devastating” childhood illness can cost affected families hundreds of thousands for treatment. A bill in Virginia is being studied by the state Health Insurance Reform Commission for the coverage of treatment for PANS/PANDAS, a mainly childhood neuropsychiatric disorder. The examination of the bill follows a unanimous tabling in a House subcommittee earlier this month. The legislation was proposed by House Delegate Patrick Hope (D-Arlington) and would require private health insurance and Medicaid to provide coverage for PANS/PANDAS treatment in order to lower the cost families must face upon diagnosis.…

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Wisconsin reaches record health insurance enrollments through Affordable Care Act

Marc
Health insurance - Wisconsin ACA record enrollment

The state saw about 266,000 sign-ups during the 2024 open enrollment period for coverage. This year’s Affordable Care Act open enrollment window for health insurance saw the highest number of Wisconsin state residents registering for coverage. The 2024 enrollment period brought coverage to over a quarter of a million people in the state. State officials made the announcement, citing health insurance enrollment data released by the federal Centers for Medicare & Medicaid Services (CMS) and from the Office of the Commissioner of Insurance. The data reflected the number of enrollments…

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