3+ week, 1+ day ago (813+ words) And even well-insured patients receive unaffordable bills in this era of high-deductible health plans, narrow insurance networks, and 20% cost sharing. These new deals are "mutually enforced monopolization," said Barak Richman, the Alexander Hamilton professor of business law at George Washington University. "It's not competition. It's more like collusion. They don't care about price." Those market factors contributed to a landscape where a dose of the antiviral Paxlovid given in a hospital costs $4,500; magnetic resonance imaging costs $15,000; and joint replacements cost $100,000. President Donald Trump has talked about the burden of health care costs since his first campaign, but he has signaled that his administration's regulators are less inclined than his predecessor's to intervene in health mergers. What this will mean in practice is unclear. In an interview with KFF Health News, Daniel Guarnera, the director of the FTC's Bureau of Competition,…...

4+ hour, 8+ min ago (479+ words) As health care costs continue to soar across the U.S., a growing number of states are setting limits on how much hospitals can charge. These policies, known as hospital payment caps, aim to curb spending by tying hospital prices to Medicare rates, which are typically far lower than what commercial insurers pay. In 2019, Oregon became the first state to implement such a cap, applying it to the health plan covering state employees. Under the policy, hospitals cannot charge the state more than double the Medicare payments for the same service. For example, if Medicare pays $1,000 for a service, the state health plan would pay no more than $2,000 under this cap." The researchers looked at financial, staffing and patient experience data from 22 Oregon hospitals affected by the cap and compared them to similar hospitals in other states from 2014 through 2023. This included financial…...

3+ week, 6+ day ago (1872+ words) Economist Vivian Ho has been researching the U.S. health care system for four decades. These days, she's focused on what she thinks are the biggest burdens on the average American: runaway hospital prices and rising health insurance premiums. She has developed a strategy for addressing high insurance premiums " one that's based on giving patients reliable information about how much they, and their insurer, would have to pay for care. The system is already working in Massachusetts. Could it be a model for the rest of the country? Ho explains to Dan Weissmann, host of "An Arm and a Leg," why she thinks this approach could help curb high prices and how listeners can help prove it by sharing their medical bills. Dan Weissmann @danweissmann Host and producer of "An Arm and a Leg." Previously, Dan was a staff reporter for Marketplace…...

3+ week, 5+ day ago (1000+ words) John Cleveland is ready to pay a lot more for his health insurance next year. He hasn't forgotten the pile of hospital bills that awaited him after he had a seizure while tending to customers in his Austin, Texas, barbershop four years ago. Once doctors hurriedly removed the dangerous tumor growing on his brain, a weeklong hospital stay, months of therapy, and nearly $250,000 worth of medical expenses followed. The coverage he has purchased for years through the Affordable Care Act marketplace covered most of those bills. "That saved my ass," said Cleveland, who owns three barbershops across the city. Small-business owners are among those who stand to lose the most should Congress let the additional, generous federal subsidies put in place during the covid-19 pandemic lapse. The looming change threatens not only their own coverage but also that of their…...

4+ week, 19+ hour ago (1214+ words) This year's Obamacare open enrollment period, which started Nov. 1 in most states, is full of uncertainty and confusion for the more than 24 million people who buy health insurance through the federal and state Affordable Care Act marketplaces. Even with sign-up season underway, the fate of the enhanced premium tax credits that make coverage more affordable for 92% of enrollees remains up in the air, with the prospect of significantly higher premiums looming. But there are steps marketplace shoppers can take to ensure they make the right choices for the upcoming plan year. 1. Understand how we got here In 2021, as part of a covid-era relief package, the ACA premium tax credits were enhanced to lower costs for previously eligible people and expand eligibility to people with incomes over 400% of the federal poverty level (which amounts to about $63,000 for one person in 2025). But…...