Mike’s Top Five Health Care Stories of 2022

It’s been a few months since I’ve talked about COVID-19, but it’s still around. The good news is that the vaccines and boosters work to minimize COVID-19’s effects. People who are vaxxed and boosted report fewer symptoms and shorter illnesses. Bivalent (updated) boosters are now recommended for everyone six months old and up, with the boosters approved for the youngest group just this month. And just in time. COVID-19 infections are rising nationally and in Louisiana.

4. Family Glitch Fix

This has been the big story since October, but it’s only number 4 on my list for the year. I’ve been talking about the Family Glitch since the IRS released new rules in October that finally break the hold it had on families, limiting the help they could get from subsidies on Healthcare.gov. The Family Glitch Fix creates a brand-new path to more affordable insurance for many families. Millions of Americans could now qualify for subsidies on their health insurance premiums if they shop on Healthcare.gov, instead of being locked into financially unaffordable employer family policies through no fault of their own. I need your help to spread the word to families who may not know they now have more affordable options to get health insurance coverage.

3. Inflation Reduction Act extends Healthcare.gov subsidies through 2025

This is a big one for anyone who shops for insurance on Healthcare.gov. Early in 2021, Congress passed the American Rescue Plan Act (ARPA). As part of that law, people buying health plans on Healthcare.gov were given an opportunity to draw down MUCH larger tax credits than had ever been available, for way higher levels of income than ever before. These tax credits were originally supposed to expire this month, but as part of the Inflation Reduction Act, Congress extended those enhanced tax credits through 2025. It costs about $20 billion a year to do this, but folks who have Healthcare.gov coverage because of those more-generous tax credits are going to be able to keep the same level of assistance for another three years. In Louisiana, 25,000 people or so are going to benefit directly from that change.

2. Colonoscopy age lowered to 45

When it comes to screening for colon cancer, 45 is the new 50. Last year, the U.S. Preventive Services Task Force changed the age to start screening for colon cancer from 50 to 45. That’s a big deal, especially in Louisiana, where we rank 5^th in the U.S. for colon cancer.

If you are 45 or older, or if you have a history of colon cancer in your family, or if you’ve been diagnosed with other bowel issues like IBD or ulcerative colitis, or you have any symptoms that make you think something may be happening in there, talk to your primary care doctor at your next check-up or appointment. She or he will guide you into the process and give you advice on when to start screening and what kind of test is right for you.

Get screened for cancer; it could save your life.

1. No Surprises Act

This one is BIG for anyone with health insurance (except a short-term medical plan). The No Surprises Act took effect Jan. 1, 2022, and, in most cases, it stops out-of-network providers from sending you a surprise, or balance, bill. I expect well more than 10 million surprise bills were stopped in 2022 alone. That’s a lot of money you and your insurance company didn’t have to pay.

The things to know: The terms of this law mostly apply during an emergency. Now, if any prudent layperson says “you look like you need medical help now,” you are in a federally defined medical emergency. So when you go to an in-network hospital but are treated by an out-of-network provider, you CANNOT be balance billed. If the provider wants a higher payment, they have to go through arbitration with your insurance company – not billing you directly. There are a few cases where out-of-network providers can balance bill you, like when you choose an out-of-network provider when in-network providers are available, or you give prior consent.

And those are my top 5 stories for 2022. Straight Talk will be coming back to you in January 2023. When things happen in the health care world, I’ll be here to give it you straight, all year long!