Access To Care

In December, the Food and Drug Administration approved a new obesity drug, Saxenda, the fourth prescription medicine the agency has given the green light to fight obesity since 2012. But even though two-thirds of adults are overweight or obese, there's a good chance their insurer won't cover Saxenda or other anti-obesity drugs.

California's health insurance marketplace, Covered California, has supported the development of more than 200 new storefronts at or near shopping centers across the state this year, each tasked with explaining the ins and outs of different health plans to holiday (and everyday) shoppers.

For two decades Atlanta restaurant owner Jim Dunn offered a group health plan to his managers and helped pay for it. That ended Dec. 1, after the Affordable Care Act made him an offer he couldn't refuse.

Subsidies under the health law for workers to buy their own coverage combined with years of rising costs in the company plan made dropping the plan an obvious — though not easy — choice.

Don Benfield of Taylorsville, N.C., makes $11 an hour working for a mobile-home parts business, selling things like replacement doors and windows.

Benfield, 51, doesn't have health insurance.

"I haven't had health care insurance in years, simply because I haven't been able to afford it, especially with food prices, how they went up," he explains.

Benfield's employer does offer health insurance coverage, even though, with fewer than 50 employees, the business is not required to.

About a year ago at a Miami-Dade County school board meeting, superintendent Alberto Carvalho was happy to announce the district and the teacher's union had just ratified a new contract.

"I believe that this contract honors and dignifies what you do every single day," he told the school board members. It included bonuses for most teachers and it settled how to handle health care expenses after yet another year of rising costs.

"We know exactly what the district pays out in terms of claims, because we are the insurance company. There's no profit to be made," he said.

Exactly what would happen to the Affordable Care Act if the Supreme Court invalidates tax credits in three dozen states where the federal government runs the program?

Legal scholars say a decision like that would deal a potentially lethal blow to the law because it would undermine the government-run insurance marketplaces that are its backbone, as well as the mandate requiring most Americans to carry coverage.

As employers try to minimize expenses under the health law, the Obama administration has warned them against paying high-cost workers to leave the company medical plan and buy coverage elsewhere.

Such a move would unlawfully discriminate against employees based on their health status, three federal agencies said in a bulletin issued in early November.

For young people, turning 21 is generally a reason to celebrate.

If they're insured through the federal health insurance marketplace that operates in about three-dozen states, however, their birthday could mean a whopping 58 percent jump in their health insurance premium in 2015, according to an analysis by researchers at the Center on Budget and Policy Priorities.

House Republicans on Friday followed through on a threat to sue President Obama over actions he has taken concerning the Affordable Care Act.

The lawsuit was filed in a federal court against the Department of Health and Human Services and the Department of Treasury.

Before Selecting Health Coverage For 2015, Good-To-Know Tips

Nov 21, 2014
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With the 2015 open enrollment period on HealthCare.gov underway, JoAnn Volk, Senior Research Fellow and Project Director at the Georgetown University Center on Health Insurance Reforms, joins Sound Medicine to discuss avoidable problems, and more. 

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