Every step taken by this administration makes insurance access harder
Congress and the Administration Are Weaponizing Paperwork to Discourage Enrollment in Marketplace Insurance www.commonwealthfund.org/blog/2025/co... by @jalisahealth.bsky.social @christinemonahan.bsky.social @commonwealthfund.org
I recently spoke with NBC10 Philadelphia reporter Tracy Davidson, investigating why more patients are seeing unexpected increases on their medical bills, often due to outpatient #facilityfees.
🎥 Watch the full NBC10 segment here: www.nbcphiladelphia.com/video/invest...
One of the most urgent questions, if this bill passes, is how states can minimize the damage (coverage losses) from these policies.
The venn diagram of answers to that question and answers to "how will system vendors try to extract as much profit as possible?" is going to have a lot of overlap.
#OBBBA also undermines bipartisan state progress to increase affordability and accessibility of care thru diabetes coverage requirements, limits on cost sharing, and #priorauth reforms, as attention/funding turn to responding to the mess #OBBBA will cause the individaul market.
Even if they avoid a gap in coverage, with every plan change, individuals w/ diabetes could face re-starting their #deductibles, going thru #priorauthorization (again!), or finding a new care provider. All of these changes could disrupt their access to care and negatively affect health/finances.
The #OneBigBeautifulBillAct is going to increase churn exponentially, kicking people off their existing coverage thanks to new paperwork burdens and eligiblity restrictions.
As Amy Killelea and I wrote in @healthaffairs.bsky.social last month, coverage transitions are really stressful if you have diabetes and need consistent access to insulin and additional health care devices and services to stay healthy.
www.healthaffairs.org/content/fore...
My team and I spend a lot of time thinking about how the private health insurance system works (and doesn't) for individuals with #diabetes who depend on #insulin.
To say the least, #OBBBA is scary.
This population will jump thru hoops to stay insured. That doesn't mean they won't get hurt.
Reminder that the median Medicaid eligibility level for pregnancy is over 2x the poverty level. Many of these people Mullin is referring to are pregnant or are children. www.kff.org/medicaid/iss...
Republicans' monster bill is designed to make people self-deport from Medicaid and Obamacare.
That creates a talking point (also not true): No one is losing eligibility!
What can we learn from states like ME, TX, and NY when it comes to outpatient hospital billing reforms?
Join @mccourtschool.bsky.social in DC on June 17 for a panel discussion exploring state-led solutions to reduce hospital outpatient charges and improve health care affordability: bit.ly/43uTEiY
What can we learn from states like ME, TX, and NY when it comes to #facilityfee reform?
Join me and @GtownCHIR in DC on June 17 for a panel discussion exploring state-led solutions to reduce #hospital outpatient charges and improve #healthcare #affordability: bit.ly/43uTEiY
#healthpolicy
What can we learn from states like ME, TX, and NY when it comes to #facilityfee reform?
Join me and @GtownCHIR in DC on June 17 for a panel discussion exploring state-led solutions to reduce #hospital outpatient charges and improve #healthcare #affordability: bit.ly/43uTEiY
#healthpolicy
PBMs get a lot of attention. But most employer #healthcare dollars are spent on medical care where another type of corporate middlemen operates: third-party administrators (TPAs) owned by large insurance companies. Via @healthaffairs.bsky.social buff.ly/y6uiYa1 #healthpolicy #healthinsurance #medsky
Read our new research for more on the current barriers to coverage, affordability, and acess in private health insurance for people with insulin-requiring diabetes and state-led policy reforms chir.georgetown.edu/diabetes/sta...
Yet millions of Americans, including many people with insulin-requiring diabetes, will regularly face #coverage losses and plan changes under the policies being debated in #Congress today.
Even just transitioning from one source of coverage to another — like switching from #Medicaid to #privateinsurance or between private plans — poses significant risks and burdens.
This population requires access to #insulin and other life-saving care every day. #Healthinsurance is not optional; losing coverage is life-threatening.
🚨 Today in Health Affairs, Amy Killelea and I highlight how ongoing efforts in #Congress to dismantle the #ACA imperil the well-being of young adults with insulin-requiring #diabetes. 🚨
Read it here: www.healthaffairs.org/content/fore...
In response to these and other concerns, states are implementing critical #policy solutions. Find out more on our website: chir.georgetown.edu/diabetes/sta...
Our research further shows that for many people living with insulin-requiring #diabetes, #priorauthorization can be a huge barrier to staying healthy.
Christina Choate shared her experience with us:
As our research shows, every person is unique, which means their #healthcare needs are, too. That’s why for people with insulin-requiring #diabetes, it’s vital that #insurance plans cover a variety of options rather than taking a one-size-fits-all approach.
Hear more from Hugh O'Hara:
Even with private health insurance, people with IRD face: Unaffordable costs, coverage gaps, and access barriers.
Even with #healthinsurance, millions of people with #diabetes face high costs and barriers to care that impact their health.
Explore our NEW @helmsleytrust.bsky.social-funded research on state #policy solutions to improve #coverage, #costsharing and #priorauthorization: bit.ly/3SwBUNS
By limiting the amount hospitals can get paid for care that that can be safely and effectively provided in an independent setting, policymakers can protect consumers and lower total spending.
Notably, there was no separate facility fee in this case: just one very high hospital lab bill. This is where site-neutral legislation can come into play.
When tests get sent to a hospital facility, consumers can end up paying $1000+ for routine lab work. Adding insult to injury, these are the "discounted" payment rates their insurance company agreed to!
kffhealthnews.org/news/article...
To learn more about outpatient facility fee billing and how states are responding, check out the research on our website: facilityfeereform.chir.georgetown.edu
#facilityfees #hospitalbilling #hospitals #healthinsurance #surprisebills #outpatient #healthcarereform
I was honored to appear on @pbsnews.org on Saturday to help explain what's going on with outpatient #facilityfee billing and how states are responding! Please check out the segment, which also highlights two stories from Minnesota families dealing with these bills.
www.pbs.org/newshour/sho...
America’s exorbitantly expensive hospitals—is featured in today’s Chartbook Top Link. Link in comment.
