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Yahoo
5 hours ago
- Business
- Yahoo
What Medicare doesn't pay for becomes hefty debt for millions of seniors
Connie Morton's husband died last November. The cause: complications from Parkinson's disease, which he had been living with for 18 years. 'During that time, there were multiple medical costs not covered by Medicare,' the Colonial Beach, Va., resident told Yahoo Finance. 'We paid what we could. For the last nine years of his life, he could no longer work. I became his caretaker, and we survived on Social Security and some help from his kids.' A growing number of retirees, like Morton, are grappling with healthcare debt due to medical bills. Medicare, which provides health insurance coverage to more than 66 million people, covers the lion's share of the cost of medical care, but not all. On average, a 65-year-old who left the workforce last year may need $165,000 in savings to cover out-of-pocket healthcare expenses throughout retirement. Earlier this year, Morton broke her ankle. 'That also added up to significant hospital bills,' she said. The combination of medical bills not covered by Medicare for the retired couple: roughly $90,000. 'I'm at a point now where I can't keep my house because the bills are much too high,' Morton said. 'I'm trying to decide what I'm going to do.' One in 10 people age 65 or older with healthcare debt owe $10,000 or more, according to a KFF study. 'That is a shocking number,' said Tricia Neuman, senior vice president of KFF. 'Some of it is credit card debt, some of it is just debt owed to a healthcare provider or a hospital. Some of it is debt to other family members.' Consider that half of all people on Medicare live on about $35,000 or less, Neuman added. 'So a $10,000 bill, or $10,000 worth of medical debt, can really be unaffordable for people and have serious consequences.' The bills that lead to the debt typically include routine healthcare services such as lab fees and diagnostic tests, dental care, and visits to the doctor, and long-term care services not covered by Medicare, according to KFF. Medicare often requires patients to pay out of pocket around 20% of their doctor bills. 'In-home care for people who are unable to take care of themselves and don't have family members that can drop everything to be there 24/7, is particularly big,' she added. 'It's a variety of healthcare expenses that can pile up and lead to medical debt.' One of the biggest culprits of credit card debt is out-of-pocket medical costs. The amount that people borrow increases dramatically with age. Half of adults 50 and older who report borrowing money to pay for healthcare in the past 12 months borrowed approximately $3,000 or more, according to a new West Health-Gallup healthcare survey. In contrast, the median amount was $750 for adults aged 30-49 and $300 for young adults aged 18-29. 'People often have higher healthcare expenses as they age, for things like dental, vision care, prescription medication, and doctor visits,' said Lori Trawinski, AARP's senior director of finance and employment. 'In many cases, healthcare costs are often charged on credit cards, which can lead to carrying that debt from month to month,' she said. That's real trouble. Anyone who has rolled over credit card balances is keenly aware of the debt that accrues when you can only pay the minimum on credit cards with interest rates topping 20%. Troubling, too, is that many people on Medicare say that they or another member of their household have delayed, skipped, or sought alternatives to needed healthcare or prescription medications due to costs, KFF found. Read more: The best ways to pay off credit card debt Anqi Chen, co-author of a brief from the Center for Retirement Research at Boston College, recently surveyed retirees with $100,000 in investable assets. 'They were largely unprepared for a medical shock,' she learned. One driver is that traditional Medicare and Medicare Advantage do not cover the cost of long-term care in nursing homes and assisted-living facilities. An apartment in an assisted-living facility had an average rate of $74,148 a year in 2024, according to the National Investment Center for Seniors Housing & Care — and costs go up as residents age and need more care. Units for dementia patients can run more than $94,000. 'If these shocks are big enough, they can devastate a household's finances,' Chen said. 'About 80% of those ages 65 and over will require some long-term care, with nearly 20% requiring high-intensity care for more than three years.'Here are some moves that can help you manage your money and avoid medical debt. Plan for healthcare expenses It's important to make healthcare costs a part of your budget and factor potential unexpected healthcare costs in your emergency fund, said Carolyn McClanahan, a certified financial planner and physician. Medicare's online searchable Plan Finder on the site allows you to review plan options. If you have a limited income, you might be eligible for Medicare's Extra Help, which covers Part D premiums and deductibles and caps drug costs. And for now, free one-on-one counseling is available through state Health Insurance Assistance Programs. Read more: What is an emergency savings fund? Don't be shy If you're having issues affording your care, ask your doctor if there is anything more cost-effective, such as changing medications or going to other facilities for testing, McClanahan said. 'And make sure you understand why your doctor is ordering tests and what they plan to do with the information. Sometimes they order tests based on 'protocol' and aren't really needed,' she added. Consult a financial adviser If you have a health shock, your financial adviser can help with a plan by reviewing your overall assets, cash flow, liquidity, and where you can rebalance investments to free up cash to cover future bills. By subscribing, you are agreeing to Yahoo's Terms and Privacy Policy Build a health savings account (HSA) If you're retiring soon, maximizing HSA contributions can be a smart move. An HSA lets you put money in on a tax-free basis, lets that money build up tax-free, and lets it come out tax-free for qualified healthcare expenses. (Some states assess state taxes.) In order to put money into an HSA, you must be enrolled in a high-deductible health plan. In those plans, you pay a lower premium per month than other types of health insurance plans, but a heftier annual deductible. Read more: HSA contribution limits for 2025: Here's how much you can save Check your credit report Get a free copy of your credit reports from In January, the Consumer Financial Protection Bureau (CFPB) finalized a rule that bans the inclusion of medical bills on credit reports used by lenders and prohibits lenders from using medical information in their lending decisions Each of the three big credit bureaus — Equifax, Experian, and Transunion — provides these free once a year. Check for accuracy and be certain that it does not include medical debt. If you see a mistake, contact the credit bureau to report it and get it removed. Read more: 6 benefits of a good credit score Scrutinize medical bills and negotiate if need be Ask for a line-item list of charges from your providers. Mistakes happen. It might be possible to set up a low-interest payment plan with the hospital or medical provider. Credit card issuers might also lower your interest rate if you have a good track record of timely payments before the medical crisis. Tap retirement accounts If you're over 59½, you can pull from your tax-deferred accounts penalty-free, although you will pay tax on the amount you withdraw. For many people, this is a speedy way to eliminate debt. However, it comes with a red-light caveat: Using your retirement accounts to whittle down debt depletes your retirement savings, and you miss out on the possibility of returns on those invested dollars. Work with a counselor A nonprofit credit counselor may also be able to negotiate with your credit card issuers if your medical debt is part of a credit card balance. You will pay a fee for the service. The Justice Department website provides a list of approved credit counseling agencies. One source to get started: National Foundation for Credit Counseling Declare bankruptcy No one really wants to go there. But if there's no relief in sight for your medical debt, this can be a do-over. A bankruptcy attorney can walk through the details with you. In general, retirement accounts are off the table during bankruptcies under federal law. Pensions, 401(k)s, 403(b)s, SEP-IRAs, and qualified profit-sharing plans are exempt from creditors. Traditional and Roth individual retirement accounts worth up to roughly $1.7 million are also protected. Social Security payments are also exempt. Kerry Hannon is a Senior Columnist at Yahoo Finance. She is a career and retirement strategist and the author of 14 books, including the forthcoming "Retirement Bites: A Gen X Guide to Securing Your Financial Future," "In Control at 50+: How to Succeed in the New World of Work" and "Never Too Old to Get Rich." Follow her on Bluesky. Sign up for the Mind Your Money newsletter Error while retrieving data Sign in to access your portfolio Error while retrieving data Error while retrieving data Error while retrieving data Error while retrieving data
Medscape
a day ago
- Business
- Medscape
Language Service Cutbacks Raise Fear of Medical Errors
SAN FRANCISCO — Health nonprofits and medical interpreters warn that federal cuts have eliminated dozens of positions in California for community workers who help non-English speakers sign up for insurance coverage and navigate the health care system. At the same time, people with limited English proficiency have scaled back their requests for language services, which health care advocates attribute in part to President Donald Trump's immigration crackdown and his executive order declaring English as the national language. Such policy and funding changes could leave some without lifesaving care, particularly children and seniors. 'People are going to have a hard time accessing benefits they're entitled to and need to live independently,' said Carol Wong, a senior rights attorney for Justice in Aging, a national advocacy group. Nearly 69 million people in the U.S. speak a language other than English, and 26 million of them speak English less than 'very well,' according to the most recent U.S. Census data available, from 2023. A KFF-Los Angeles Times survey from that year found that immigrants with limited English proficiency reported more barriers accessing health care and worse health than English-proficient immigrants. Health advocates fear that, without adequate support, millions of people in the U.S. with limited English proficiency will be more likely to experience medical errors, misdiagnosis, neglect, and other adverse outcomes. During the start of the pandemic in 2020, ProPublica reported that a woman with coronavirus symptoms died in Brooklyn after missing out on timely treatment because emergency room staffers could not communicate with her in Hungarian. And, at the height of the crisis, The Virginian-Pilot first reported that a Spanish translation on a state website erroneously stated that the covid-19 vaccine was not necessary. In 2000, President Bill Clinton signed an executive order aimed at improving access to federal services for people with limited English proficiency. Research shows language assistance results in higher patient satisfaction, as well as fewer medical errors, misdiagnoses, and adverse health outcomes. Language services also save the health care system money by reducing hospital stays and readmissions. Trump's order repealed Clinton's directive and left it up to each federal agency to decide whether to maintain or adopt a new language policy. Some have already scaled back: The Department of Homeland Security and the Social Security Administration reportedly reduced language services, and the Justice Department says it is reviewing guidance materials. A link to its language plan is broken. It's unclear what the Department of Health and Human Services intends to do. HHS did not respond to questions from KFF Health News. An HHS plan implemented under President Joe Biden, including guidance during public health emergencies and disasters, has been archived, meaning it may not reflect current policies. However, HHS's Office for Civil Rights still informs patients of their right to language assistance services when they pick up a prescription, apply for a health insurance plan, or visit a doctor. And the office added protections in July that prohibit health providers from using untrained staff, family members, or children to provide interpretation during medical visits. It also required that translation of sensitive information using artificial intelligence be reviewed by a qualified human translator for accuracy. Those safeguards could be undone by the Trump administration, said Mara Youdelman, a managing director at the National Health Law Program, a national legal and health policy advocacy organization. 'There's a process that needs to be followed,' she said, about making changes with public input. 'I would strongly urge them to consider the dire consequences when people don't have effective communication.' Even if the federal government ultimately doesn't offer language services for the public, Youdelman said, hospitals and health providers are required to provide language assistance at no charge to patients. Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race or national origin, protections that extend to language. And the 2010 Affordable Care Act, which expanded health coverage for millions of Americans and adopted numerous consumer protections, requires health providers receiving federal funds to make language services, including translation and interpretation, available. 'English can be the official language and people still have a right to get language services when they go to access health care,' Youdelman said. 'Nothing in the executive order changed the actual law.' Insurers still need to include multi-language taglines in their correspondence to enrollees explaining how they can access language services. And health facilities must post visible notices informing patients about language assistance services and guarantee certified and qualified interpreters. State and local governments could broaden their own language access requirements. A few states have taken such actions in recent years, and California state lawmakers are considering a bill that would establish a language access director, mandate human review of AI translations, and improve surveys assessing language needs. 'With increasing uncertainty at the federal level, state and local access laws and policies are even more consequential,' said Jake Hofstetter, policy analyst at the Migration Policy Institute. The Los Angeles Department of Public Health and San Francisco's Office of Civic Engagement and Immigrants Affairs said their language services have not been affected by Trump's executive order or federal funding cuts. Demand, however, has dropped. Aurora Pedro of Comunidades Indígenas en Liderazgo, one of the few medical interpreters in Los Angeles who speaks Akatek and Qʼanjobʼal, Mayan languages from Guatemala, said she has received fewer calls for her services since Trump took office. And other pockets of California have reduced language services because of the federal funding cuts. Hernán Treviño, a spokesperson for the Fresno County Department of Public Health, said the county cut the number of community health workers by more than half, from 49 to 20 positions. That reduced the availability of on-the-ground navigators who speak Spanish, Hmong, or Indigenous languages from Latin America and help immigrants enroll in health plans and schedule routine screenings. Treviño said staffers are still available to support residents in Spanish, Hmong, Lao, and Punjabi at county offices. A free phone line is also available to help residents access services in their preferred language. Mary Anne Foo, executive director of the Orange County Asian and Pacific Islander Community Alliance, said the federal Substance Abuse and Mental Health Services Administration froze $394,000 left in a two-year contract to improve mental health services. As a result, the alliance is planning to let go 27 of its 62 bilingual therapists, psychiatrists, and case managers. The organization serves more than 80,000 patients who speak over 20 languages. 'We can only keep them through June 30,' Foo said. 'We're still trying to figure it out — if we can cover people.'
Axios
a day ago
- Business
- Axios
How the GOP megabill may roll back the Affordable Care Act
The massive Republican budget bill working its way through Congress has mostly drawn attention for its tax cuts and Medicaid changes. But it would also take steps to significantly roll back coverage under the Affordable Care Act, with echoes of the 2017 repeal-replace debate. Why it matters: The bill that passed the House before Memorial Day includes an overhaul of ACA marketplaces that would result in coverage losses for millions of Americans and savings to help cover the cost of extending President Trump's tax cuts. It comes after a growth spurt that saw ACA marketplace enrollment reach new highs, with more than 24 million people enrolling for 2025, according to KFF. The House's changes would likely reverse that trend, unless the Senate goes in a different direction when it picks up the bill next week. Driving the news: The changes are not as sweeping as the 2017 effort at repealing the law, but many of them erect barriers to enrollment that supporters say are aimed at fighting fraud. Brian Blase, president of Paragon Health Institute and a health official in Trump's first administration, said Republicans are focusing on rolling back Biden-era expansions "that have led to massive fraud and inefficiency." The CBO estimates the ACA marketplace-related provisions would lead to about 3 million more people becoming uninsured. Cynthia Cox, a vice president at KFF, said while the changes "sound very technical" in nature, taken together "the implications are that it will be much harder for people to sign up for ACA marketplace plans." What's inside: The bill would end automatic reenrollment in ACA plans for people getting subsidies, instead requiring them to proactively reenroll and resubmit information on their incomes for verification. It would also prevent enrollees from provisionally receiving ACA subsidies in instances where extra eligibility checks are needed, which can take months. If people wound up making more income than they had estimated for a given year, the bill removes the cap on the amount of ACA subsidies they would have to repay to the government. Some legal immigrants would also be cut off from ACA subsidies, including people granted asylum and those in their five-year waiting period to be eligible for Medicaid. What they're saying: In a letter to Congress, patient groups pointed to the various barriers as "unprecedented and onerous requirements to access health coverage" that would have "a devastating impact on people's ability to access and afford private insurance coverage." The letter was signed by groups including the American Cancer Society Cancer Action Network, American Diabetes Association and American Lung Association. Between the lines: A last-minute addition to the bill would also make a technical but important change that increases government payments to insurers in ACA marketplaces. That would have the effect of reducing the subsidies that help people afford premiums and save the government money, by reducing the benchmark silver premiums that are used to set the subsidy amounts. Democrats are concerned that if Congress also allows enhanced ACA subsidies to expire at the end of this year, the combined effect would be even higher premium increases for enrollees next year. Insurers that already are planning their premium rates for next year say the Republican funding changes are throwing uncertainty into the mix. "Disruption in the individual market could also result in much higher premiums," the trade group AHIP warned in a statement on the bill. The big picture: Blase said changes like ending automatic reenrollment are needed to increase checks that ensure people are not claiming higher subsidies than they're entitled to. "I think what happened during the Biden years led to massive fraud and improper spending, and that needs to be rolled back," he said. Cox said another way to address fraud would be to target shady insurance brokers, rather than enrollees themselves. She estimated that marketplace enrollment could fall by roughly one third from all the changes together.
Washington Post
a day ago
- Business
- Washington Post
Future of health policy in the United States
Jeanne Lambrew Director of Health Care Reform and Senior Fellow, The Century Foundation Drew Altman President and CEO, KFF Additional speakers to be announced. The following content is produced and paid for by a Washington Post Live event sponsor. The Washington Post newsroom is not involved in the production of this content. Mark Bertolini CEO, Oscar Health
Newsweek
2 days ago
- Health
- Newsweek
More Than a Million Americans Removed From Health Care Plan in One Month
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. More than one million Americans lost health coverage in a single month at the end of last year as states continued to unwind pandemic-era coverage protections. According to data published by KFF, a nonprofit health policy research and news organization, national enrollment in Medicaid and the Children's Health Insurance Program (CHIP) dropped from 79,569,888 in November 2024 to 78,532,341 in December 2024, a net loss of 1,037,547 enrollees. Newsweek has contacted the Centers for Medicare & Medicaid Services (CMS) outside of regular hours via email for comment. Why It Matters The unwinding process has significantly reshaped Medicaid enrollment across the U.S. Under federal rules in place during the pandemic, states were required to keep most Medicaid recipients continuously enrolled, even if their eligibility status changed. That requirement expired in March 2023, allowing states to resume removing individuals from the program. Since the unwinding began, enrollment has steadily declined, driven by both eligibility losses and procedural disenrollments—when individuals lose coverage due to missing paperwork or administrative errors rather than no longer qualifying. File photo: Medicaid activists wait to enter the House Energy and Commerce. File photo: Medicaid activists wait to enter the House Energy and Commerce. Tom Williams/CQ Roll Call via AP What To Know The drop represents one of the many steep single-month declines recorded since states began redetermining eligibility in early 2023, following the end of the COVID-19 public health emergency declaration. The December enrollment figure of 78.5 million is the lowest recorded figure since late 2020. For comparison, total Medicaid enrollment peaked at 94.6 million in April 2023, during the pandemic-era continuous coverage period. State-by-state trends also show uneven disenrollment rates, with Utah reporting disenrollment rates as high as 31 percent between March 2023 and December 2024, followed by Texas with 30 percent, while South Dakota saw a 2 percent decrease in enrollment in the same time frame. California, Maine, Alaska, Connecticut, and Oregon were other states that only saw a single-figure disenrollment rate during that time. KFF reported that child enrollment in the two programs is now below pre-pandemic enrollment in 13 states, while adult enrollment is below pre-pandemic levels in 7 states. Although, while in some states' disenrollment happened rapidly, returning to enrollment rates matching the early 2020 numbers, national Medicaid and CHIP enrollment is not yet back to pre-pandemic levels. What People Are Saying Eileen Sullivan-Marx, dean and professor of New York University Rory Meyers College of Nursing, told Newsweek: "It would be hard to know what caused this one month decline, however, it does reinforce that there is a projected trend downward continuing. It could be that some of the state differentials that month are skewing the whole data downward between November and December. I also notice that this is mostly a steeper downward trend for adults. The tendencies presently occurring have to do with disenrollments and the difficulty to re-enroll once disenrolled. If states do not make sure that there is a smooth way to re-enroll or enroll on a regular basis then there could be sharper decline in those enrolled in Medicaid." She added: "Disenrollments that are occurring simply because it is hard to re-enroll have consequences for those who need coverage in terms of accessing health care, getting medications, having to pay privately for a nursing home stay." Ben Anderson, the deputy senior director of health policy at Families USA, a health care-focused consumer advocacy group, told KFF in September: "We have seen some amazing coverage expansion in places like Oregon and California. But if you live in Texas, Florida, and Georgia, since the pandemic your health coverage has been disrupted in ways that were preventable by state leaders." What Happens Next As the unwinding continues, more reductions in enrollment are expected. With millions already having lost health coverage, concerns remain about access to care for low-income individuals and families.
