An Arm and a Leg

By October 1, at least two million seniors will get alarming notices: Their health plans — which they got through Medicare Advantage, the version of Medicare run by private insurance companies — will disappear at the end of the year. Many of them will be stuck without a lot of options. In some cases, no other companies in their area may offer Medicare Advantage plans to replace them. Almost three million seniors got stuck in similar situations last year, and experts say the scenario will likely keep playing out for years to come. For years, critics have warned that Medicare Advantage plans expose seniors to big risks: The insurance company can decline to cover meds and treatment. And when they do approve treatments, finding a provider who takes your plan can be a huge challenge. Now, there’s a new and growing risk: Those plans could disappear, without a viable replacement. In this episode, we take a close look at the fallout in one state: Minnesota, where the collapse of a major Medicare Advantage carrier last year led to “total chaos,” according to the director of the state’s Medicare assistance agency — and where everyday heroes stepped up to support one another. Plus, we zoom out to look at how private health insurance companies have enmeshed themselves into Medicare as a whole, how that’s affecting the choices in front of us, and what we might do about it. Looking for help with Medicare? Find your state’s SHIP chapter. Check out our previous episode on Medicare vs. Medicare Advantage. Read about Medicare pitfalls to avoid: Part One and Part Two Here's a transcript of this episode. Send your stories and questions. Or call 724 ARM-N-LEG. Reporting for this story was supported in part by Arnold Ventures. And... donations from listeners are our single biggest source of funding. We'd love for you to pitch in today. Support the show: https://armandalegshow.com/support/ See omnystudio.com/listener for privacy information.

Employer-sponsored health insurance covers 165.6 million Americans. It’s the default. For lots of workers, it’s a key reason to accept a job offer, or to stay in a job. But that system is slowly imploding. As premiums have grown explosively — the average employer plan now prices out at $27,000 for family coverage — businesses have passed more costs onto their workers. And, as STAT News reporter Bob Herman wrote in July: America's Small Businesses are Giving Up on Health Insurance. That story kicked off a series, Out of Pocket, Out of Reach, with a subtitle that says it all: “How America's Employer-Based Healthcare System Continues to Crumble in Slow Motion.” Bob covers the business of health care for STAT News. His rigorous investigative journalism recently earned him the coveted title of “UnitedHealth’s least favorite reporter.” He joins us to unpack how the skyrocketing cost of providing health insurance is affecting companies large and small. And he talks with Dan about how the hidden nature of those costs obscures our understanding of just how much the larger health care system is squeezing out of us, eroding our wages and even our freedom to leave crappy jobs. Here's a transcript of this episode. Subscribe to our newsletter, First Aid Kit. Send your stories and questions. Or call 724 ARM-N-LEG. Of course we’d love for you to support this show. Support the show: https://armandalegshow.com/support/ See omnystudio.com/listener for privacy information.

We’re bringing back a favorite episode from 2023 that raises a question as relevant as ever: What if we had a decent, publicly-funded health system, available to everybody, with or without insurance? We’ve got one, says Dr. Ricardo Nuila. It’s where he works. And it could be a model for the whole country. Yes, really. That’s the pitch he made in his 2023 book, The People’s Hospital: Hope and Peril in American Medicine. It’s a love letter to Houston’s Ben Taub hospital, and an argument for bringing Ben Taub’s model, efficient, innovative, and cheap, to the rest of the country. And if that seems unlikely in today’s political climate, well: Ben Taub’s wild origin story was plenty unlikely too. That story takes us to the 1960s, when Dutch novelist and playwright Jan de Hartog moved to Houston. He fell in love with the bustling, futuristic home of NASA and the Astrodome. But he also discovered the city’s dreadful underside: a neglected charity hospital where largely African-American patients are left to seek health care in unsanitary and unsafe, hellish, conditions. De Hartog and a group of Quaker volunteers waged a campaign to change that, and eventually found an unlikely ally who brought it over the finish line. The People’s Hospital is a heck of a book. We might want to start a book group someday, just to talk about it. If you want to grab a copy, here’s a link. (Or: Audiobook, or ebook.) Here's a transcript of this episode. Send your stories and questions. Or call 724 ARM-N-LEG. And of course we’d love for you to support this show. Support the show: https://armandalegshow.com/support/ See omnystudio.com/listener for privacy information.

Last May, just a few months into the second Trump Administration, changes to federal health programs were happening at a bewildering pace. We brought in KFF Heath News Chief Washington Correspondent Julie Rover to help give us — and you — a big picture look at what some changes would mean. A year-and-change later, we wanted to check back in. We talk about the “crumbling Jenga tower” of public health infrastructure, the fallout from cuts to Obamacare subsidies, and Medicaid, and what Julie sees happening in 2028 and beyond (including a whisper of hope.) Plus, we get an update on Julie’s growing t-shirt collection and a new series she’s starting on her health policy news podcast What the Health? You can read a transcript of this episode here. Want to dive deeper into those state Medicaid cuts we talked about? Julie did a whole episode of What the Health? about them. Listen here. Want weekly updates from the team, including some of our most practical advice for dealing with the outrageous cost of health care? Sign up for our newsletter, First Aid Kit. Send your stories and questions. Or call 724 ARM-N-LEG. Of course we’d love for you to support this show. Support the show: https://armandalegshow.com/support/ See omnystudio.com/listener for privacy information.

After her husband L was hospitalized for a severe mental health crisis, Teressa barely had a moment to breathe before the health insurance denials started coming in, burying their family in medical debt. But Teressa’s a fighter, and an organized one at that — ready to endure months of back and forth until she stumbled on a "secret door" to reversing her husband’s insurance denials: the external review. In this episode of Paper Trail, a podcast from the investigative journalists at ProPublica, health care reporter Duaa Eldeib and host Jessica Lussenhop follow Teressa's journey to discovering this powerful and little-known tool — and putting it to work. Could an external review help you? Check out ProPublica’s write-up, which includes the types of denials eligible for this kind of appeal. And for more stories about appealing health insurance denials, you can check out our Starter Pack, which features episodes like this one about writing a killer appeal letter. Here's a transcript of this episode. Want weekly updates from the team, including some of our most practical advice for dealing with the outrageous cost of health care? Sign up for our newsletter, First Aid Kit. Send your stories and questions. Or call 724 ARM-N-LEG. Of course we’d love for you to support this show. Support the show: https://armandalegshow.com/support/ See omnystudio.com/listener for privacy information.