The hottest Medicaid Substack posts right now

And their main takeaways

A big discovery, Medicaid cuts, states removing fluoride, drug price questions, and more.

Your Local Epidemiologist • 1287 implied HN points • 19 May 25

A recent breakthrough in genetics used new tools to fix a baby's rare disease by editing their DNA. This could lead to treatments for many other genetic disorders.
Florida is removing fluoride from drinking water, which could affect many people's dental health. This decision might inspire other states to follow suit.
Proposed cuts to Medicaid could leave 8.6 million people without health coverage, highlighting the importance of contacting lawmakers about healthcare access.

Ten States Have Held Out on Medicaid Expansion. It's Left Millions of Americans Without Health Coverage.

HEALTH CARE un-covered • 439 implied HN points • 23 Sep 24

🏥 Health Politics Medicaid Legislation Public Health

Ten states have not expanded Medicaid, leaving millions of people without health coverage. These states have some of the highest rates of uninsured residents.
Many people in the coverage gap are working but still can't afford health insurance. Their incomes are too high for Medicaid but too low for ACA subsidies.
The refusal to expand Medicaid often comes from political choices, not a lack of need. Many residents want the expansion, but their state governments are not listening.

New Netflix Horror Flick “The Deliverance” Tackles Medicaid Troubles, Medical Debt

HEALTH CARE un-covered • 599 implied HN points • 05 Sep 24

🏥 Health Politics Medicaid Medical Debt Health care Insurance Patient rights

The movie 'The Deliverance' highlights the struggles of a family facing both a demonic presence and real-life issues with the U.S. healthcare system. It shows how complicated and scary healthcare can feel for many families.
Many healthcare providers are dropping Medicaid patients, making it harder for those in need to find care. The film illustrates the true horror of loved ones having to pay medical bills out-of-pocket when Medicaid support is unavailable.
Medical debt is a serious problem in the U.S., affecting countless families. The film ends with the family battling real financial burdens, reminding viewers that there's no easy fix for medical bills.

Medicaid and Medicare Claims Managed by Insurers Are Rising. Why Aren’t They Worried About Their Profits?

HEALTH CARE un-covered • 819 implied HN points • 11 Jun 24

🏥 Health Politics Healthcare policy Insurance Practices Medicaid Medicare Profit Margins

Insurers are seeing more claims for Medicaid and Medicare, but they aren't worried about profits. This is surprising to many people looking at the rising costs.
Insurance companies can limit patient care by using tactics like prior authorization, which makes it hard for people to get needed treatment. This helps them keep their profits high.
Medicare Advantage plans allow insurers to charge seniors more out-of-pocket costs. Insurers do this to maximize their profits while still getting a steady payment from the government.

BIG INSURANCE 2023: Revenues reached $1.39 trillion thanks to taxpayer-funded Medicaid and Medicare Advantage businesses

HEALTH CARE un-covered • 779 implied HN points • 02 Apr 24

🏥 Health Politics Insurance Policy Medicaid Medicare Healthcare Reform Corporate Influence

Health insurance companies in the U.S. made $1.39 trillion in revenue last year. A lot of this money came from government programs like Medicaid and Medicare Advantage.
The Affordable Care Act (ACA) helped many people get insurance but also allowed insurers to profit tremendously. This has led to higher out-of-pocket costs for consumers and medical debts for many families.
Big insurance companies have grown a lot over the last decade, and their executives are making huge salaries. Reform is needed to control these companies and make healthcare more affordable for everyday people.

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UnitedHealth Group, the Biggest Private Health Insurer on the Planet, Made $8.5 Billion in Profits in Q1 2024

HEALTH CARE un-covered • 619 implied HN points • 16 Apr 24

🏥 Health Politics Insurance Medicare Medicaid Healthcare Regulation

UnitedHealth Group made $8.5 billion in profits in the first quarter of 2024, showing strong financial growth despite recent challenges. Their revenues have tripled over the last decade, indicating a significant increase in business.
A big part of their success comes from government programs like Medicare and Medicaid, where enrollment has jumped in recent years. This growth has helped them dominate the market alongside a few other large competitors.
Despite their financial success, many healthcare providers are struggling due to a cyberattack on a subsidiary. Advocates are concerned that profit-focused practices may lead to patients not receiving necessary care.

Without health insurance, poverty is just a medical bill away

American Inequality • 609 implied HN points • 12 Jul 23

🏥 Health Politics Insurance Medicaid Medical Debt Healthcare system

Lack of health insurance leads to inequalities and higher child mortality rates.
High costs hinder insurance enrollment, with many uninsured Americans being from low-income households.
Employer-based health insurance in the U.S. has roots in historical events and presents challenges like 'job-lock' and lack of coverage for gig-workers.

[VIDEO] Poor Americans to feel the burn from health insurer Elevence's decision in Medicaid dispute

HEALTH CARE un-covered • 519 implied HN points • 28 Aug 23

🏥 Health Politics Healthcare access Insurance Issues Medicaid Public Health Policy advocacy

Elevance is a health insurer with high denial rates for claims, affecting patients' access to necessary treatments. Many poor Americans are struggling because of this.
In Ohio and Virginia, there's a conflict between Elevance and a major hospital system, leading to unpaid claims amounting to $100 million. This dispute means Medicaid patients may need to find different hospitals for care.
Lawmakers need to step in and address the unfair practices of health insurers like Elevance. This is crucial for protecting low-income Americans who rely on Medicaid services.

Elevance and other for-profit insurers find new scrutiny from lawmakers over their denials of care for Medicaid patients

HEALTH CARE un-covered • 419 implied HN points • 17 Aug 23

🏥 Health Politics Healthcare Policy Insurance Medicaid Legislation

Elevance and other for-profit insurers are denying many care requests for Medicaid patients. In fact, Elevance has a denial rate over 34%, which is really high.
Lawmakers are starting to investigate these denial practices more closely. Congress is looking into how insurers use 'prior authorization' to say no to needed treatments.
In Ohio, Elevance is having contract disputes with hospitals, impacting Medicaid patients' access to care. This means patients might struggle to find alternative hospitals that will cover their treatments.

Are Medicare and Medicaid Patients Required to Weigh-In?

Weight and Healthcare • 199 implied HN points • 09 Nov 22

🏥 Health Politics Policy Healthcare Public Health Medicare Medicaid

Medicare and Medicaid do not require patients to weigh-in at their appointments, despite common misconceptions.
Physicians are incentivized to discuss weight and create treatment plans for patients with a BMI over 24.9 due to quality score impact on reimbursement.
Patients on Medicare/Medicaid can opt-out of weigh-ins, and providers must exclude them from performance calculations, even though technical challenges may arise.

A CLOSER LOOK: The Mid Year Earnings of 7 Big For-Profit Insurance Companies

HEALTH CARE un-covered • 219 implied HN points • 16 Aug 22

🏥 Health Politics Insurance Medicare Medicaid Profitability Government funding

The largest for-profit insurance companies made $43.8 billion in profits and had $620.6 billion in revenue, mostly from taxpayer money. This shows how much they benefit financially from government programs.
Three major insurers control 80% of the pharmacy benefit market. This means they have a huge influence over how prescription medications are managed and priced.
A large number of Americans are underinsured, with 43.4% lacking sufficient coverage. This highlights a growing issue in healthcare, where many people struggle to afford medical care despite having insurance.

Big insurer Anthem took in $38 billion in the first 3 months of 2022. Most of it by far came from taxpayers.

HEALTH CARE un-covered • 199 implied HN points • 28 Apr 22

🏥 Health Politics Health Insurance Public funding Medicare Medicaid

Anthem's revenue has shifted significantly, with most of its income now coming from taxpayer-funded programs like Medicare and Medicaid rather than private-paying customers.
The employer-based health insurance system is declining rapidly as many employers can no longer afford to provide coverage, affecting the number of private-paying customers.
Despite growing profits largely from private-paying clients, many of Anthem's customers are struggling to afford out-of-pocket costs, leading to increased financial hardships.

UnitedHealth Group has fewer private paying customers than in 2012, but its remaining customers are paying way more in premiums and deductibles

HEALTH CARE un-covered • 79 implied HN points • 18 Oct 22

🏥 Health Politics Health Policy Insurance Medicaid Medicare

UnitedHealth Group has fewer private customers than it did ten years ago, but the ones it has are paying significantly more in premiums and deductibles.
The average family plan has become much more expensive, and employees are shouldering more of the costs than they used to.
As insurance companies keep raising prices while offering less coverage, people are essentially paying more for fewer benefits over time.

Anthem, the USA’s second biggest insurer, has had spectacular growth over the past 10 years.

HEALTH CARE un-covered • 0 implied HN points • 23 Jul 21

🏥 Health Politics Healthcare Insurance Medicaid Medicare

Anthem, a major health insurer in the USA, has seen huge growth, mainly from government programs like Medicaid and Medicare. This means more taxpayers are funding their rise.
Over the past decade, most new members in Anthem's plans came from government programs instead of private insurance. This shift highlights how the Affordable Care Act helped many people gain health coverage.
Even with rising costs for their customers, Anthem continues to profit well by purchasing its own stocks. This move benefits investors more than it helps the people who need health insurance.