El juicio de Florida sobre la elegibilidad para Medicaid, que resultó en la pérdida de cobertura de 1.8 millones de personas, se pospuso indefinidamente porque el juez que supervisó el caso tuvo una muerte en su familia. La demanda colectiva sostiene que la Agencia de Florida para la Administración de Atención Médica y el Departamento de Niños y Familias de Florida terminaron indebidamente la cobertura de Medicaid para individuos sin proporcionar razones específicas ni permitirles apelar la decisión antes de la terminación. Los defensores dicen que está relacionado con un informe reciente que muestra que Florida ha dado de baja a unos 600 mil niños de Medicaid y del Programa de Seguro Médico Infantil desde que se levantaron las protecciones de cobertura relacionadas con el COVID. Norín Dollard es analista de políticas de Kids Count del Florida Policy Institute y cree que el estado podría hacer más para evitar la pérdida de cobertura.

"Quiero decir, esa es una pérdida significativa de atención médica. Los niños son un poco diferentes a los adultos porque, en términos generales, Medicaid solo está disponible para personas con bajos ingresos. Pero es mucho más probable que los niños sean elegibles para Medicaid, y es una parte sustancial del seguro médico para niños," indicó además la entrevistada.

Los abogados estatales inicialmente intentaron posponer el caso, argumentando que el lunes en la mañana no era tiempo suficiente para prepararse eficazmente. Sin embargo, el juez no estuvo de acuerdo. Ahora, ambas partes tendrán que esperar para saber cuándo se fijará una nueva fecha del juicio y si el estado se verá obligado a restablecer la cobertura y revisar la forma en que notifica a los destinatarios.

Dollard dice que hay varios desafíos legales en juego, incluido uno por parte del estado, que demandó al Centro de Servicios de Medicaid para impedir que aplique la elegibilidad continua de 12 meses en el programa CHIP del estado.

"El estado explica que pueden cancelar la cobertura por falta de pago, mientras que los Centros de Servicios de Medicaid y Medicare dicen que no pueden, por lo que actualmente estamos esperando ver qué ordenará el juez al respecto," insistió también Dollard.

Sin embargo, la demanda colectiva, presentada por el Programa Nacional de Ley de Salud y el Florida Health Justice Project en agosto pasado, representa a cinco demandantes nombrados y a una clase más amplia de personas excluidas de Medicaid desde el 31 de marzo de 2023. En última instancia, Dollard espera que el estado puede hacer más para que el proceso sea más fluido y los avisos pueden ser más específicos para que los destinatarios puedan responder a las solicitudes del estado.



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World Hepatitis Day is this Sunday, and for the Oregon Health Authority, it's an opportunity to promote its plan to eliminate hepatitis across the state.

Released in March, the plan includes major goals and strategies to limit the spread of hepatitis A, B and C over the next six years. It's gotten new attention after 2,400 patients in Oregon hospitals were potentially exposed to hepatitis and HIV earlier this month.

Concerns are high, but epidemiologist Dr. Dean Sidelinger, Oregon's state health officer, said people should be aware of the threats of hepatitis, but not anxious.

"In day-to-day times, people should feel safe and confident in going to the doctor," he said. "The risk of exposure to these viruses is extremely low in most cases."

Hepatitis is inflammation of the liver, and contagious viruses are among the causes. Sidelinger said he's confident Oregon has the technology and resources to fully eliminate the threat.

While many people may have heard of hepatitis, they may not fully understand how prevalent it is in their communities. According to OHA data, the proportion of chronic hepatitis C cases among people in their 20s tripled between 2010 and 2019.

Sidelinger said there's a good chance most Oregonians know someone who is affected by chronic hepatitis.

"It can seem out of the blue to be talking about hepatitis and [a] hepatitis awareness day, but this is a disease that affects many individuals," he said. "But the good news is, everyone can take steps to protect themselves."

The OHA says you can help prevent the spread of hepatitis by washing hands and fresh produce, staying current on vaccinations, avoiding sharing needles, and getting tested regularly. These tips and more are part of the state's plan to eliminate hepatitis by 2030.


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CoveredCA announced Wednesday that the average premium for plans on the marketplace will rise 7.9% in 2025, but subsidies are expected to blunt the impact and even lower costs for many consumers.

The Biden-Harris administration's Inflation Reduction Act caps premiums at 8.5% of income for many, and goes even further for those with low incomes.

Rachel Linn Gish, director of communications for the nonprofit Health Access California, said the state has put the federal funds to good use.

"Because of this financial help," she said, "California has been able to take even further steps to lower costs for many CoveredCA enrollees by eliminating deductibles and reducing copays for many health services such as doctors' visits, lab work, generic drugs."

However, the enhanced premium subsidies in the IRA will expire next year, sending costs soaring unless Congress extends them. If not, Gish said, she expects premiums to rise 60% to 80%, costing thousands more per year. Opponents of the extension have cited the need to limit federal spending.

Gish said if the federal premium help ends, people could start seeing much higher deductibles.

"Without the federal assistance, California stands to lose $1.7 billion in assistance, which the state can only backfill a fraction of," she said, "which means consumers could again see deductibles of $5,000 or more."

Other big changes are on the way. Starting Nov. 1, about 40,000 income-eligible DACA recipients in California will be able to apply for premium subsidies through Covered California.

Connecticut insurance companies are requesting rate increases. Companies want a more than 8% increase for individuals and an almost 12% increase for small groups. However, insurance costs are already problematic for residents. A 2022 survey shows 46% of people delayed important medical care due to coverage costs.

Liz Dupont-Diehl, associate director of the Connecticut Citizen Action Group, said unaffordable insurance is all too common.

"It is an unfortunate American right of passage to spend hours a week appealing claims denials, or dealing with rising copays, and surprise costs. Even those of us lucky enough to think we have good coverage are continually surprised by hings that are not covered," she said.

Of the legislative solutions lawmakers can take, polls show voters across party lines support the government setting limits on out-of-pocket medical care costs for people with insurance.

Connecticut's Insurance Department will host an informational meeting for people to share their experiences and hear testimony. It will be held from 9 a.m. to 1 p.m. on August 20 at the Legislative Office Building in Hartford and over Zoom.

One way Connecticut's General Assembly can better regulate insurance companies is by increasing transparency surrounding pharmacy benefit managers. A recent Federal Trade Commission report finds the six largest pharmacy benefit managers manage 95% of the country's prescriptions.

Dupont-Diehl said this can help people better understand why certain claims get denied.

"We would be interested in knowing exactly which claims are denied based on ZIP code, based on race and ethnicity, based on age, based on gender," she continued.

She notes that much of what needs to be done to fix health care can be done at the federal level, although states can take the lead. Part of Connecticut's 2023 budget calls for the state's Insurance Department to work with the Office of Health Strategy to study ways to make care more affordable.