News You Need: Medicare, Caregiving, Penalties, & More

This week we bring you information that may be useful to you and updates from a few states . . .state update medicare

National News:

  1. It was announced last week that Medicare will require hospitals to post their standard prices online and make electronic medical resources more readily available to patients. Hospitals are already required to disclose prices public, but this is supposed to make it easier for patients to access. The hope is that with more information on prices, patients can make better-educated choices about where to go for their medical care. Also, starting in 2021, Medicare will base part of a hospital’s payments on how well it makes computerized records available to patients. If you have additional questions about the cost of cancer care, you can find information about navigating finances after cancer at CancerFinances.org.
  2. Family members are increasingly finding themselves thrust into the work of caregiving when a family member or other loved one is diagnosed with a serious medical condition like cancer. Most states require professional caregivers to undergo many hours of training. So how do family members get the training they need? First, it is incredibly important to engage the health care team to make sure you are prepared for taking the best care of your loved one.  Here is an interesting article with some additional best practices.
  3. Did you think the individual mandate to have health insurance was repealed? Well, it wasn’t. In 2019, the penalty for not having health insurance coverage will drop to $0, but that still means that you will face a penalty of $695 or 2.5% of your household income, for not having insurance in 2018.  But, there are 4 new ways to avoid penalties for not having health insurance.  If you meet one of these requirements, you can apply for an exemption:
    1. Live in an area with no marketplace plans
      • Note: there are no areas in 2018 where this applies
    2. Live in an area where there is only one insurer selling marketplace plans
      • Note: 26% of marketplace enrollees live in a county with only one insurer
    3. Can’t find an affordable marketplace plan that doesn’t cover abortion
      • Note: In 2016, 31 states didn’t offer plans that cover abortions
    4. Experience “personal circumstances” that make it difficult for them to buy a marketplace plan, including not being able to find a plan that gives them access to specialty care they need

These hardship exemptions can be requested retroactively going back to 2016. If you have already filed a tax return and paid a penalty, you can file an amended return. It is unclear how many people who apply for these exemptions. In 2017, 11 million tax returns claimed an exemption and 4 million people paid penalties of nearly $3 billion for not having health insurance.

New York:

The New York State Legislature is currently considering legislation that would allow physicians to prescribe life-ending medication to terminally ill patients. This bill has been considered for years, but has yet to receive a vote. Adult patients who are terminally ill would have to meet strict guidelines to get the medication, including having two doctors sign off on the patient’s request. If New York passes this legislation, it would join California, Colorado, Hawaii, Oregon, Vermont, Washington, and the District of Columbia, which have all death with dignity laws.


A few weeks ago, we shared how Maine’s Governor, Paul LePage is refusing to implement the voter proposition to expand Medicaid coverage in Maine, which was passed in November 2017.  Roughly 80,000 people in Maine were supposed to get access to Medicaid on July 2, 2018, but that seems unlikely as there has been little movement and deadlines have been ignored. Supporters of Medicaid expansion are being forced to look at litigation options to enforce the implementation of the expansion.

Advocacy groups in Idaho, Nebraska, and Utah are also working on ballot initiatives to expand Medicaid in those states. Virginia’s legislature is also working to find a path towards expansion.

Stay tuned for the latest news  . . .

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Monica Bryant