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Remaking Health Care

This column explores how health reform is changing the ways in which we pay for and deliver health care in the U.S. It also highlights the ways in which our current system is falling short on measures of coverage, access and affordability. On any given week, that could mean a look at how Republican plans to repeal Obamacare could reshape the individual insurance market, how the safety net system is adapting to new financial pressures, or how the trend of doctors and hospitals merging into ever-larger entities is driving up costs. We also explore health care costs and whether the Affordable Care Act or its successor plans can live up to the promise to rein them in. Throughout, we keep watch on how the goals of health reform intersect with the shaping power of markets and human behavior. Contributors include veteran health journalist Trudy Lieberman and independent health journalist Kellie Schmitt, with occasional contributions from independent journalists such as Susan Abram and Sara Stewart.

Picture of Trudy  Lieberman

As health costs keep rising and insurers recalibrate their Obamacare plans, House Speaker Paul Ryan has proposed creating separate risk pools to insure sick people and lower premiums.

Picture of Kellie  Schmitt

By aggressively documenting a patient’s conditions, insurers can inflate the amount of money they get from Medicare Advantage patients. Here's what reporters should understand about the hidden practice of "upcoding."

Picture of Trudy  Lieberman

Victims of the Affordable Care Act's "family glitch" include the Devors family of Salem, Ill., who now find themselves caught in a dire health crisis, without adequate coverage.

Picture of Gerald Kominski

So-called "surprise bills" can leave unsuspecting patients on the hook for thousands of dollars. And market solutions haven't fixed the problem so far, writes UCLA health policy expert Gerald Kominski.

Picture of Judy  Silber

Do undocumented residents have to pay the Obamacare penalty for not having health insurance? Despite advocates' efforts, you might be surprised at how much confusion there is — even from tax preparers.

Picture of Trudy  Lieberman

On health care, the talk from presidential candidates has been way too sketchy and uninformative, argues contributing editor Trudy Lieberman. Policy details remain vague, and no one has gotten to the heart of what ails the system.

Picture of Kellie  Schmitt

A new Health Matters webinar this week explored just how different the health care spending map looks when researchers are given access to price and spending data from private insurance plans.

Picture of Trudy  Lieberman

With the third open enrollment period closing last Sunday and predictions suggesting fewer sign-ups than expected, it’s time to be clear about why it’s so difficult to get the remaining holdouts insured.

Picture of Trudy  Lieberman

Are insurance policies too complicated to understand? They always have been and always will be unless there are changes in the way policies work, or until there are rules to make it easier for buyers to compare options.

Picture of Judy  Silber

A complaint filed this week alleges that California is engaging in unlawful discrimination by paying some of the lowest reimbursement rates in the country to the state’s Medicaid providers. As some coverage pointed out, the notion that low rates are limiting access to doctors is “not unfounded."

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