health insurance

For people who make too much money to qualify for health insurance subsidies on the individual market, there may be no Goldilocks moment when shopping for a plan. No choice is just right.

A policy with an affordable premium may come with a deductible that's too high. If the copayments for physician visits are reasonable, the plan may not include their preferred doctors.

These consumers need better options, and in early August federal officials offered a strategy to help bring down costs for them.

To an outsider, the fancy booths at a June health insurance industry gathering in San Diego, Calif., aren't very compelling: a handful of companies pitching "lifestyle" data and salespeople touting jargony phrases like "social determinants of health."

But dig deeper and the implications of what they're selling might give many patients pause: a future in which everything you do — the things you buy, the food you eat, the time you spend watching TV — may help determine how much you pay for health insurance.

Jackie Fortier / StateImpact Oklahoma

The air medical field has grown tremendously since the 1980s. Air ambulances take patients to the nearest hospital, which often means crossing state lines. But a legal quirk means paying for a life-saving flight can lead to financial ruin. Congress is mulling a fix, but some air ambulance companies say it could have unintended consequences.

It's a club no one wants to join, but many Americans these days find themselves automatically eligible for the "Bill of the Month" club.

Kaiser Health News and NPR began collecting people's health care bills for examination early this year. We have waded through roughly 500 submissions, choosing just one each month to decode and dissect. (If you'd like to submit your story or bill, you can do it here.)

Sherry Young just wanted to be able to walk without pain.

About three years ago, she began to experience sharp pain in her left foot. Her big toe had become crooked and constantly rubbed up against the adjacent toe, making it painful to run, walk or even stand. "I could not walk without intense pain unless I had a pad underneath my toes for cushioning," Young said.

An orthopedic surgeon told her that he could fix her problem for good. "He thought my foot was hitting the ground too hard and causing pain," said Young. "That's what he was trying to correct."

There already have been more than a dozen reasons U.S. consumers can use to avoid paying the penalty for not having health insurance. Now the federal government has added four more.

These "hardship exemptions" let people off the hook if they can't find a marketplace plan that meets not only their coverage needs but also reflects their view if they are opposed to abortion.

For the past year, the Trump administration and Republicans in Congress have led a charge to roll back the Affordable Care Act, signaling an openness to changes at the state level.

Now, Idaho has jumped in, with the insurance department saying Wednesday it will allow insurers to ignore some ACA rules on plans not sold on the marketplace. The department aims to make these state-based plans less costly. Several of the changes are viewed by the health law's supporters as hits to its core consumer protections.

Friday is the last day to enroll in a health insurance plan through the federal government's insurance exchange, HealthCare.gov.

And in a little office park in Northern Virginia, Brima Bob Deen is dealing with the rush.

This post was updated Dec. 14 at 9:30 a.m. to note that Maryland extended enrollment until Dec. 22.

Gene Kern, 63, retired early from Fujifilm, where he sold professional videotape. "When the product became obsolete, so did I," he says, "and that's why I retired."

Open enrollment on the federal health law's marketplace — HealthCare.gov — ends Friday, and most people who want a plan for next year need to meet the deadline.

But some consumers who miss the cutoff could be surprised to learn they have the opportunity to enroll later.

"While a lot of people will be eligible ... I am still worried that a lot of consumers won't know it," says Shelby Gonzales, a senior policy analyst at the Center on Budget and Policy Priorities.

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