INSIDER
Texas is slashing $607 million in Medicaid funding from program for students with disabilities
Read full article: Texas is slashing $607 million in Medicaid funding from program for students with disabilitiesSchool officials says the state decision to cut federal money likely will hurt their ability to recruit and retain critical staff for students with disabilities.
Blue Cross and Blue Shield of Texas to remove Houston’s MD Anderson Cancer Center from Medicare, Medicaid networks
Read full article: Blue Cross and Blue Shield of Texas to remove Houston’s MD Anderson Cancer Center from Medicare, Medicaid networksBlue Cross and Blue Shield of Texas announced it has made the decision to remove MD Anderson Cancer Center in Houston from its Medicare Advantage PPO, Blue Cross Medicare Advantage HMO, and Medicaid networks effective Nov. 1, 2024.
Navigating health care: How those with chronic conditions and disabilities can find tailored support
Read full article: Navigating health care: How those with chronic conditions and disabilities can find tailored supportDual-eligible individuals -- those who qualify for both Medicare and Medicaid -- often face complex health needs and barriers to accessing care.
Elevance makes a late cut to its 2024 forecast after seeing trouble in Medicaid
Read full article: Elevance makes a late cut to its 2024 forecast after seeing trouble in MedicaidElevance Health surprised Wall Street with a rare, late-year guidance cut Thursday after a jump in Medicaid costs marred its third quarter.
Texas’ order to ask hospital patients’ citizenship status renews focus on the state’s large uninsured population
Read full article: Texas’ order to ask hospital patients’ citizenship status renews focus on the state’s large uninsured populationOn Nov. 1, hospitals will begin asking patients their citizenship status. But data suggests uninsured citizens, not immigrants, cost Texas hospitals more.
Voters with disabilities are feeling ignored by presidential candidates
Read full article: Voters with disabilities are feeling ignored by presidential candidatesA new report from Rutgers University estimates that about 40.2 million eligible voters in the quickly approaching U.S. presidential election are disabled.
In South Texas congressional race, Monica De La Cruz and Michelle Vallejo spar over health care
Read full article: In South Texas congressional race, Monica De La Cruz and Michelle Vallejo spar over health careThe topic is playing a major role in one of Texas’ only competitive congressional races this year as the competitors debate Medicare, abortion and expanding coverage.
Despite warnings, Texas rushed to remove millions from Medicaid. Eligible residents lost care.
Read full article: Despite warnings, Texas rushed to remove millions from Medicaid. Eligible residents lost care.Texas officials acknowledged some errors after they stripped Medicaid coverage from more than 2 million people, most of them children. A ProPublica and Texas Tribune review of records shows that these mistakes and others were preventable.
Even as state mental health spending rises, private psychiatric hospitals struggle to stay open
Read full article: Even as state mental health spending rises, private psychiatric hospitals struggle to stay openTexas hasn’t increased Medicaid rates for inpatient health care at private hospitals in 16 years, falling behind other states.
More mental health services needed for Texas children, what experts are seeing more of
Read full article: More mental health services needed for Texas children, what experts are seeing more ofAs we go back to school a lot of focus turns to children’s wellbeing and mental health. According to the CDC, anxiety and depression affect almost 10% of kids 3 to 17 years old.
Judge refuses to extend timeframe for Georgia's new Medicaid plan, only one with work requirement
Read full article: Judge refuses to extend timeframe for Georgia's new Medicaid plan, only one with work requirementA federal judge has ruled that the Biden administration complied with the law when it declined to grant an extension to Georgia’s year-old Medicaid plan, which is the only one in the country that has a work requirement for recipients of the publicly funded health coverage for low-income people.
Can a Medicaid plan that requires work succeed? First year of Georgia experiment is not promising
Read full article: Can a Medicaid plan that requires work succeed? First year of Georgia experiment is not promisingBy now, Georgia officials expected their new Medicaid plan to provide health insurance to 25,000 low income residents.
North Carolina's Medicaid expansion program has enrolled 500,000 people in just 7 months
Read full article: North Carolina's Medicaid expansion program has enrolled 500,000 people in just 7 monthsMore than 500,000 North Carolina residents have enrolled in state's Medicaid expansion program in the seven months since it was launched.
Forced labor, same-sex marriage and shoplifting are all on the ballot in California this November
Read full article: Forced labor, same-sex marriage and shoplifting are all on the ballot in California this NovemberForced labor, same-sex marriage and shoplifting are among the 10 statewide ballot measures California voters will consider.
Cook Children’s sues Texas over potential Medicaid contract loss
Read full article: Cook Children’s sues Texas over potential Medicaid contract lossFor years, Cook’s Children, two other children’s hospitals have administered Medicaid health coverage plans. Canceling their contracts would put jobs and coverage at risk, they say.
Houston dental clinic operator who orchestrated $6 million fraud scheme given prison sentence
Read full article: Houston dental clinic operator who orchestrated $6 million fraud scheme given prison sentenceProsecutors say Rene Gaviola, 68, employed his son at Floss Family Dental Care, even though he isn't a licensed dentist, submitted several fake claims and pocketed the money.
With 1 out of 3 Californians on Medicaid, doctors push ballot measure to force state to pay more
Read full article: With 1 out of 3 Californians on Medicaid, doctors push ballot measure to force state to pay moreCalifornia Gov. Gavin Newsom wants to back out of a deal he made last year to pay doctors more money to treat Medicaid patients.
State rejects health insurers' pleas to halt plan that will shake up coverage for 1.8 million Texans
Read full article: State rejects health insurers' pleas to halt plan that will shake up coverage for 1.8 million TexansAffected Texans who receive Medicaid coverage would be shifted to new insurers next year if the state health and human services agency sticks to its plan. It’s now up to the executive commissioner to make a final decision.
California governor criticized for proposal to eliminate health benefit for some disabled immigrants
Read full article: California governor criticized for proposal to eliminate health benefit for some disabled immigrantsCalifornia Gov. Gavin Newsom is facing criticism for his proposal to eliminate an optional Medicaid benefit for some disabled immigrants.
Tennessee, Delaware to become first states to offer free diapers for Medicaid families
Read full article: Tennessee, Delaware to become first states to offer free diapers for Medicaid familiesTennessee will soon become the first state in the country to offer free diapers to families enrolled in the state’s Medicaid program after receiving federal approval, state officials have confirmed.
Biden administration says 100,000 new migrants are expected to enroll in 'Obamacare' next year
Read full article: Biden administration says 100,000 new migrants are expected to enroll in 'Obamacare' next yearRoughly 100,000 immigrants who were brought to the U.S. as children are expected to enroll in the Affordable Care Act’s health insurance next year.
Mississippi Medicaid expansion plan could struggle for bipartisan support, Democratic leader says
Read full article: Mississippi Medicaid expansion plan could struggle for bipartisan support, Democratic leader saysThe Mississippi House Democratic leader says a Medicaid expansion plan endorsed by Republican leaders could struggle for bipartisan support.
West Virginia and North Carolina's transgender care coverage policies discriminate, judges rule
Read full article: West Virginia and North Carolina's transgender care coverage policies discriminate, judges ruleA federal appeals court has ruled that West Virginia and North Carolina’s refusal to cover certain health care for transgender people with government-sponsored insurance is discriminatory.
State’s premature release of bid proposal info touches off new battle over $116 billion in Medicaid contracts
Read full article: State’s premature release of bid proposal info touches off new battle over $116 billion in Medicaid contractsThe early release of documents meant a single competitor got an early look at the other bidders’ playbooks before final winners were announced.
Mississippi lawmakers haggle over possible Medicaid expansion as their legislative session nears end
Read full article: Mississippi lawmakers haggle over possible Medicaid expansion as their legislative session nears endTop Mississippi lawmakers have started negotiating on what could become a landmark plan to expand Medicaid coverage to tens of thousands of people in one of the poorest states in the U.S. But even with Republicans controlling both the state House and Senate, it’s far from clear that they will reach a compromise.
Texas families could lose at-home nursing under stricter Medicaid rule
Read full article: Texas families could lose at-home nursing under stricter Medicaid ruleSome children who receive private duty nursing, a more continuous type of medical care in their homes, could lose their ability to live at home if an HHSC rule change goes into effect.
Proposed changes to state Medicaid plans could shake up health coverage for 1.8 million low-income Texans
Read full article: Proposed changes to state Medicaid plans could shake up health coverage for 1.8 million low-income TexansThe move, which has not been finalized, would drop three large health plans run for two decades by nonprofit children’s hospitals.
One-fourth of people dropped from Medicaid still aren't insured, survey shows
Read full article: One-fourth of people dropped from Medicaid still aren't insured, survey showsA new survey shows that almost a quarter of people who have been dropped from Medicaid during post-pandemic eligibility reviews are still uninsured.
Years ago, Texas hustled to get kids on state health care. Now it’s kicking them off.
Read full article: Years ago, Texas hustled to get kids on state health care. Now it’s kicking them off.Texas’ recent unwinding of Medicaid and CHIP has been criticized, dropping more than a million people eligible for the health insurance programs. Decades ago, Texas officials got kids health insurance in record time.
A woman’s fight to escape the hospital shows Medicaid’s limits for disabled Texans
Read full article: A woman’s fight to escape the hospital shows Medicaid’s limits for disabled TexansStaffing shortages and mismanaged care can delay when Texans on some Medicaid programs are discharged from hospitals. This can cost the state more and take a toll on patients and caregivers.
Idaho considers a ban on using public funds or facilities for gender-affirming care
Read full article: Idaho considers a ban on using public funds or facilities for gender-affirming careIdaho lawmakers are expected to vote on a bill that would ban the use of any public funds for gender-affirming care, including for state employees using work health insurance and for adults covered by Medicaid.
Arizona legislation to better regulate rehab programs targeted by Medicaid scams is moving forward
Read full article: Arizona legislation to better regulate rehab programs targeted by Medicaid scams is moving forwardA Navajo state senator in Arizona says she's hoping for final approval of her bill to tighten regulations for rehab facilities amid widespread fraud that has bilked hundreds of millions in Medicaid dollars.
Mississippi has the nation's worst infant mortality. It will allow earlier Medicaid to help babies
Read full article: Mississippi has the nation's worst infant mortality. It will allow earlier Medicaid to help babiesMississippi Republican Gov. Tate Reeves has signed a new law that will allow women to receive Medicaid coverage earlier in pregnancy.
Mississippi eyes quicker Medicaid coverage in pregnancy to try to reduce deaths of moms and babies
Read full article: Mississippi eyes quicker Medicaid coverage in pregnancy to try to reduce deaths of moms and babiesMississippi could start providing Medicaid coverage earlier in pregnancy in a bid to improve health outcomes for moms and babies.
More Texans than ever before enrolled in ACA health plans in 2024, feds say
Read full article: More Texans than ever before enrolled in ACA health plans in 2024, feds sayThe final enrollment numbers, released Wednesday, touched off discussions over whether Texas should create its own marketplace exchange.
'Obamacare' sign-ups surge to 20 million, days before open enrollment closes
Read full article: 'Obamacare' sign-ups surge to 20 million, days before open enrollment closesThe Biden administration says 20 million people have enrolled for health insurance through the Affordable Care Act marketplaces, with still a few days left for signing up.
A push to expand Medicaid has Kansas governor embracing politics and cutting against her brand
Read full article: A push to expand Medicaid has Kansas governor embracing politics and cutting against her brandDemocratic Gov. Laura Kelly is more aggressive and openly political in pushing to expand Medicaid in Kansas as the Republican-controlled Legislature prepares to open its annual session.
There's a glimmer of hope for broader health coverage in Georgia, but also a good chance of a fizzle
Read full article: There's a glimmer of hope for broader health coverage in Georgia, but also a good chance of a fizzleLong-held Republican opposition to broader health care coverage may be softening in Georgia and Mississippi.
How the Texas vision for seamless mental health care fell apart over 60 years
Read full article: How the Texas vision for seamless mental health care fell apart over 60 yearsA lack of private providers, a swamped community mental health system, and low insurance reimbursement have cut off many in Texas from basic mental health services.
Families say autism therapy helped their kids. Indiana's Medicaid cuts could put it out of reach
Read full article: Families say autism therapy helped their kids. Indiana's Medicaid cuts could put it out of reachStarting with the new year, Indiana will implement a universal reimbursement rate for a therapy commonly used by children with autism, at a rate significantly less than what healthcare providers received on average in the past.
Nearly 1.7 million Texans lose Medicaid as state nears end of “unwinding”
Read full article: Nearly 1.7 million Texans lose Medicaid as state nears end of “unwinding”Texas has booted the most people from Medicaid of any state in the country. A majority of those removed lost their health insurance coverage because of procedural reasons.
Here’s how you can check if your medical professional actually has a license in the state of Texas
Read full article: Here’s how you can check if your medical professional actually has a license in the state of TexasUnlicensed men and women in the state of Texas have been caught on numerous occasions carrying out extreme medical procedures even though they are not qualified.
“The first child is the one that pays the most”: How one family carved out Medicaid coverage for a rare treatment
Read full article: “The first child is the one that pays the most”: How one family carved out Medicaid coverage for a rare treatmentGabe Nolasco was born without a vital immune system gland. His family spent years in quarantines and advocating to state insurance so they could keep him alive.
Therapist’s ex-wife sentenced to nearly 5 years for defrauding Medicaid of more than $600K, stealing patient information
Read full article: Therapist’s ex-wife sentenced to nearly 5 years for defrauding Medicaid of more than $600K, stealing patient informationA 48-year-old Katy woman has been sentenced to prison for defrauding Medicaid of more than $600,000, the United States Department of Justice announced Tuesday.
The Biden administration is slow to act as millions are booted off Medicaid, advocates say
Read full article: The Biden administration is slow to act as millions are booted off Medicaid, advocates sayError-ridden state reviews have purged millions of the poorest Americans from the Medicaid program in recent months.
It's time to buy health insurance through the marketplace. Experts suggest doing your research first
Read full article: It's time to buy health insurance through the marketplace. Experts suggest doing your research firstThe time to shop for health insurance on the Affordable Care Act’s coverage marketplaces is back.
Why a North Texas suburban school district is opening a new health clinic for students on Medicaid
Read full article: Why a North Texas suburban school district is opening a new health clinic for students on MedicaidThe new clinic met resistance from a vocal group of parents who raised concerns the district was overstepping its authority in caring for students.
‘An understaffed and broken system’: 900,000 Texans have lost Medicaid as others struggle to access SNAP benefits
Read full article: ‘An understaffed and broken system’: 900,000 Texans have lost Medicaid as others struggle to access SNAP benefitsTexas Democrats in Congress are urging the federal government to audit the state’s Medicaid eligibility system
Many states are expanding their Medicaid programs to provide dental care to their poorest residents
Read full article: Many states are expanding their Medicaid programs to provide dental care to their poorest residentsA growing number of states are offering dental care to low-income adults who once had to rely on charity or the emergency room to treat their tooth problems.
Appeals court takes up transgender health coverage case likely headed to Supreme Court
Read full article: Appeals court takes up transgender health coverage case likely headed to Supreme CourtA federal appeals court is considering cases out of North Carolina and West Virginia that could have significant implications on whether individual states are required to cover health care for transgender people with government-sponsored insurance.
Fake Arizona rehab centers scam Native Americans far from home, officials warn during investigations
Read full article: Fake Arizona rehab centers scam Native Americans far from home, officials warn during investigationsHundreds of Native Americans have been recruited to addiction treatment centers in Phoenix from states as far away as Montana in a widespread billing scheme that mostly targeted Medicaid’s American Indian Health Program.
Georgia Medicaid program with work requirement off to slow start even as thousands lose coverage
Read full article: Georgia Medicaid program with work requirement off to slow start even as thousands lose coveragePublic health advocates say Georgia appears to be doing little to promote its new Medicaid plan or enroll people in it.
Feds raise concerns about long call center wait times as millions dropped from Medicaid
Read full article: Feds raise concerns about long call center wait times as millions dropped from MedicaidFederal officials are raising concerns that long call center wait times may be contributing to a surge in the number of people losing Medicaid health care coverage.
TribCast: Texas’ tough border security tactics under scrutiny
Read full article: TribCast: Texas’ tough border security tactics under scrutinyIn this week’s episode, we discuss the half-million people booted from Texas’ Medicaid rolls and the state’s deployment of razor wire and buoys along the border in Eagle Pass.
3 arrested in $142M genetic testing fraud scheme using Houston company; $7.1M in assets seized
Read full article: 3 arrested in $142M genetic testing fraud scheme using Houston company; $7.1M in assets seizedThe Office of the Attorney General’s Medicaid Fraud Control Unit has arrested three people associated with the genetic testing company ApolloMDx for their alleged involvement in a major healthcare fraud scheme to fraudulently bill Medicare approximately $142 million.
‘Scared out of my mind’: A family scrambles after their disabled 3-year-old loses Medicaid
Read full article: ‘Scared out of my mind’: A family scrambles after their disabled 3-year-old loses MedicaidWhen Texas started scrubbing people from Medicaid after a three-year pause on removals during the pandemic, one family lost the insurance coverage that helped provide all treatments for their medically complex child.
GOP nominee says he would renew push for Medicaid work requirement if elected governor in Kentucky
Read full article: GOP nominee says he would renew push for Medicaid work requirement if elected governor in KentuckyRepublican Daniel Cameron says he would move quickly as Kentucky’s governor to revive a push to require some able-bodied adults to work in exchange for Medicaid health coverage.
Confusion and stress abound for 500,000 Texans bumped from Medicaid
Read full article: Confusion and stress abound for 500,000 Texans bumped from MedicaidContinuous Medicaid coverage ended in April. Many of the roughly half-million people stripped from the rolls don’t even know they’ve lost coverage yet.
Biden administration asks employers to give more help to workers who lose Medicaid
Read full article: Biden administration asks employers to give more help to workers who lose MedicaidThe Biden administration is asking employers to give workers who lose Medicaid coverage more time to land health insurance through their jobs.
500,000 Texans have been dropped from the Medicaid rolls since April
Read full article: 500,000 Texans have been dropped from the Medicaid rolls since AprilAdvocates are calling for a halt to removals until the state can account for why more than 80% of the people who lost Medicaid coverage were eliminated for “procedural” reasons, like not responding to messages from the state.
Georgia launches Medicaid expansion in closely watched test of work requirements
Read full article: Georgia launches Medicaid expansion in closely watched test of work requirementsGeorgia is offering a new bargain to some adults without health insurance beginning Saturday: Go to work or school and the state will cover you.
Families worry over the future of Medicaid caregiver payments that were expanded during the pandemic
Read full article: Families worry over the future of Medicaid caregiver payments that were expanded during the pandemicFamilies of severely disabled children across the country are worried about the future of crucial Medicaid payments they started receiving to provide care during the COVID-19 pandemic.
Federal judge strikes down Florida's ban on Medicaid funding for transgender treatment
Read full article: Federal judge strikes down Florida's ban on Medicaid funding for transgender treatmentA federal judge has struck down Florida rules championed by Gov. Ron DeSantis restricting Medicaid coverage for transgender treatments.
Navajo Nation declares widespread Medicaid scam in Arizona a public health state of emergency
Read full article: Navajo Nation declares widespread Medicaid scam in Arizona a public health state of emergencyA widespread Arizona Medicaid scam that has left an unknown number of Native Americans homeless on the streets of metro Phoenix is being declared a public health state of emergency by the Navajo Nation as fraudulent sober living homes lose their funding and turn former residents onto the streets.
More than 1 million people are dropped from Medicaid as states start a post-pandemic purge of rolls
Read full article: More than 1 million people are dropped from Medicaid as states start a post-pandemic purge of rollsAbout 1.5 million people have lost Medicaid coverage in more than two dozen states as a post-coronavirus pandemic purge of the rolls gets underway.
$6M pediatric dental fraud scheme revealed: Dental clinic operator, 2 managers charged
Read full article: $6M pediatric dental fraud scheme revealed: Dental clinic operator, 2 managers chargedCharges have been filed against an operator and two managers at a local dental clinic for their roles in a $6 million Medicaid fraud and kickback scheme, U.S. Attorney Alamdar S. Hamdani announced.
This year, Texas lawmakers zeroed in on existing health care programs, leaving bolder measures by the wayside
Read full article: This year, Texas lawmakers zeroed in on existing health care programs, leaving bolder measures by the waysidePregnant moms on Medicaid will get health care coverage for a year, patients will get more detailed billing and nurses will get help with school loans. But efforts failed to gain steam for legalizing fentanyl test strips, increasing the pool of mental health professionals who accept Medicaid and expanding Medicaid benefits to more Texans.
Texas Legislature passes bill to offer new moms a year of Medicaid coverage
Read full article: Texas Legislature passes bill to offer new moms a year of Medicaid coverageThe Texas House and Senate voted for the proposal, capping a yearslong effort to extend coverage for low-income moms. Medicaid covers half of all births in Texas, and coverage currently expires after two months.
Texas Senate OKs extending postpartum Medicaid — with an anti-abortion amendment
Read full article: Texas Senate OKs extending postpartum Medicaid — with an anti-abortion amendmentNew moms will be able to keep their health insurance for a full year under a proposal the Senate passed Sunday. A last-minute anti-abortion amendment means the bill will go back to the House.
Texans would get one year of Medicaid coverage after giving birth under bill advanced by Senate committee
Read full article: Texans would get one year of Medicaid coverage after giving birth under bill advanced by Senate committeeA bipartisan coalition of lawmakers and advocates have thrown their support behind extending Medicaid coverage for a full year after childbirth. The full Senate will now have the opportunity to consider the bill, which has already passed the House.
Rhode Island governor signs bill to fund abortion coverage for state workers and Medicaid recipients
Read full article: Rhode Island governor signs bill to fund abortion coverage for state workers and Medicaid recipientsRhode Island Gov. Daniel McKee has signed a bill into law that would let state funds be used to pay for health insurance plans that cover state workers and Medicaid recipients seeking abortions.
New work requirements for federal aid? GOP pushes proposals in debt talks
Read full article: New work requirements for federal aid? GOP pushes proposals in debt talksWork requirements for federal aid programs have emerged as a sticking point in ongoing negotiations over raising the nation’s debt ceiling, and President Joe Biden has signaled openness to a possible compromise even as many in his party have balked.
As public health emergency ends, pandemic-era support programs have already been fading away
Read full article: As public health emergency ends, pandemic-era support programs have already been fading awayThe formal end of the national Public Health Emergency on Thursday is largely a symbolic and psychological step, representing the country’s formal emergence from the COVID-19 pandemic.
Congress eyes work rules for millions covered by Medicaid
Read full article: Congress eyes work rules for millions covered by MedicaidMore than half a million of the poorest Americans would be left without health insurance under legislation passed by House Republicans that would require people to work in exchange for health care coverage through Medicaid.
When it comes to upping mental health services, Texas has a Medicaid problem
Read full article: When it comes to upping mental health services, Texas has a Medicaid problemTexas wants to expand mental health services, but many mental health providers do not accept Medicaid because of its lower payment rate.
Texas House moves to expand Medicaid coverage to new moms for a year after childbirth
Read full article: Texas House moves to expand Medicaid coverage to new moms for a year after childbirthNew moms would be able to maintain their health insurance for up to a year after childbirth under the proposal, which also passed the House last session. The Senate previously reduced it to just six months of coverage.
Biden says he's expanding some migrants' health care access
Read full article: Biden says he's expanding some migrants' health care accessPresident Joe Biden says his administration is expanding eligibility for Medicaid and the Affordable Care Act’s health insurance exchanges to hundreds of thousands of immigrants who were brought to the U.S. illegally as children.
Pandemic Medicaid coverage is ending. Here’s what that means for people using Medicaid health benefits.
Read full article: Pandemic Medicaid coverage is ending. Here’s what that means for people using Medicaid health benefits.Texas is reviewing the eligibility of people on Medicaid health plans or Healthy Texas Women now that pandemic Medicaid coverage is ending. Here’s what that means, how to renew your health coverage or find other options if you no longer qualify.
“I love my babies. But that doesn’t mean it’s easy”: One mother’s struggle to survive in pro-life Texas
Read full article: “I love my babies. But that doesn’t mean it’s easy”: One mother’s struggle to survive in pro-life TexasPregnancy forced Destiny Williams to quit her job. She almost died during childbirth. Now with a newborn in tow, she’s struggling to build a more stable life for her and her children.