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From surprise bills to sky-high deductibles, the American health care system is not working perfectly for many. But what’s the fix?

This hour: Democratic presidential candidates have a wide variety of ideas to reform how Americans are insured, from a “public option” to “Medicare for All”. But what do these terms mean? We break it down.

Frankie Graziano / Connecticut Public Radio

Senator Richard Blumenthal is warning consumers about a proposal from the federal government that could force them to pay more for potentially inadequate repairs if they're involved in a car accident.

SCANTAUR / Istock/Thinkstock

Plaintiffs in a nationwide class-action lawsuit are challenging how Medicare pays out for health coverage of hospitalizations and related rehabilitative services.

Nicole Leonard / Connecticut Public Radio

Kristen Whitney Daniels was 15 years old when she was diagnosed with Type 1 diabetes — a lifelong disease.

“As if I wasn’t awkward enough as a sophomore in high school, I also acquired this chronic illness that completely upended my life,” she said.

Nicole Leonard / Connecticut Public Radio

Democratic legislators and government officials stood with a small crowd of supporters at the Legislative Office Building in March to announce that it was time that Connecticut created a public option health insurance program. 

Nicole Leonard / Connecticut Public Radio

Democratic lawmakers are pushing a new public option health care proposal, angering Republican colleagues so close to the end of the legislative session.

Supporters are calling the new plan Connecticut Option — it’ll be a program overseen by the state and offered through insurance companies or a network created by the state.

The part of the street where Ridge Road meets Lexington Avenue in Danbury was closed after a telephone pole snapped and took down power lines.
Frankie Graziano / Connecticut Public Radio

One year after tornadoes ripped through Connecticut, many residents are still struggling with post-storm cleanup. In response, federal lawmakers announced Monday that they’re reintroducing what they call the DEBRIS Act (Diversifying Emergency Benchmarks for the Recovery of Individuals after Storms). 

Stakeholders Square Off Over Proposed Public Option For Health Coverage

May 9, 2019
A sign at the Health Care Action Day at the state Capitol on May 1.
Christopher Hoffman / C-HIT.org

While tolls, bonding and the budget have dominated this legislative session, a battle has been quietly brewing over the creation of a state-administered health insurance public option for small businesses.

Pharmacy Benefit Managers Scrutinized For Role In Drug Price Increases

Apr 24, 2019
Marion Bradley fills a prescription for one of her customers. She is the lead pharmacist and co-owner of Beacon Falls Pharmacy.
Carl Jordan Castro / C-HIT.org

Pharmacy benefit managers – the middlemen who negotiate drug purchases for insurers and large buyers – are coming under growing scrutiny and criticism both in Connecticut and nationwide for their role in the sharp rise of prescription drugs.

Nicole Leonard / Connecticut Public Radio

State lawmakers revealed details Thursday on how Connecticut could create and run its own public option health care plan, which would compete with private insurers.

Harriet Jones / Connecticut Public Radio

Connecticut’s insurance industry has been taking stock of its year, and a new report says the state should still pride itself on being the insurance capital of the world.

The federal judge in Texas who ruled the Affordable Care Act unconstitutional earlier this month said that the law can remain in effect while under appeal.

U.S. District Court Judge Reed O'Connor wrote in his ruling filed on Sunday that "many everyday Americans would otherwise face great uncertainty during the pendency of appeal."

Former Access Health CEO, State Contractor Pay To Settle Ethics Violation

Dec 26, 2018
Former Access Health CEO James Wadleigh.
Kyle Constable / CTMirror.org

James Wadleigh, the former CEO of Connecticut’s health insurance exchange, Access Health CT, has paid a $5,000 civil fine for accepting employment with a state contractor within one year of leaving his post, the Office of State Ethics said in a settlement released Wednesday.

Editor's note: This story was updated with enrollment figures made available on Dec. 19.

About 8.5 million people enrolled in health plans for 2019 through the federal HealthCare.gov website by the Dec. 15 deadline.

That's about 367,000 fewer people than signed up during the 6 week open enrollment season last year, a decline of about 4 percent, according to new numbers from the Department of Health and Human Services.

Gary Ombler / Thinkstock

Open enrollment season is well underway, and Connecticut’s insurance commissioner is warning consumers against junk health plans - after herself being targeted for a scam. 

When Kathy Klute-Nelson heads out on a neighborhood walk, she often takes her two dogs — Kona, a boxer, and Max, a small white dog of questionable pedigree who barrels out the front door with barks of enthusiasm.

The 64-year-old resident of Costa Mesa, Calif., says she was never one to engage in regular exercise — especially after a long day of work. But about three years ago, her employer, the Auto Club of Southern California, made her and her colleagues an offer she couldn't refuse: Wear a Fitbit, walk every day and get up to $300 off your yearly health insurance premiums.

Jim Wadleigh, former CEO of Access Health CT.
Chion Wolf / Connecticut Public Radio

The former CEO of the state’s health care exchange has resigned from his new private sector job, just weeks after taking it. Jim Wadleigh now says his move may have contravened state ethics laws.

Chion Wolf / WNPR

Some more good news for Connecticut homeowners who are struggling with crumbling foundations -- many will now be able to deduct the cost of repairs from their federal taxes over the next two decades. 

Mary Anne Williams

Connecticut homeowners who have crumbling foundations will soon be able to apply for reimbursement through a new state-sponsored fund. The specialty insurance company set up to process claims launched a website Monday that gives guidelines on who will be eligible, what documentation they will need, and what will be covered. 

Analysts are estimating that Hurricane Michael has caused billions of dollars of damage and will create a substantial loss for insurers, but the industry is expected to cope — once again avoiding the kind of meltdown that Florida saw in the 1990s, after Hurricane Andrew.

Ryan Caron King / WNPR

CVS has cleared the biggest hurdle in its plan to acquire Hartford-based health insurer Aetna. The deal was given the green light Wednesday by federal anti-trust regulators.

Ryan Caron King / WNPR

When CVS agreed to acquire Aetna, they halted a plan to move the Hartford-based company’s headquarters to New York City. Connecticut has been breathing a sigh of relief that one of the capital’s largest employers isn’t ditching the state.

Consumers Feel Sticker Shock As Out-Of-Pocket Health Care Costs Rise

Oct 2, 2018
Lauren Goldstein (left) and her wife, Joan Goldstein, are fighting their insurance company's refusal to pay a $3,094 ER bill.
Carl Jordan Castro / C-HIT

In February, Joan Goldstein of Monroe received a panicked call for help from her wife, Lauren Goldstein. Joan found Lauren rolled up like a ball on the floor in her office bathroom. “I have never seen her sick in 15 years,” Joan said.

The U.S. Coast Guard working in the aftermath of Hurricane Florence in Newport, North Carolina.
Jacob B. Derry / U.S. Air Force

As Hurricane Florence came ashore in the Carolinas, insurance companies prepared to process thousands of claims. The storm combined high winds and continues to bring massive amounts of rain. 

Blue tarps still dot rooftops, homes lack electricity needed to refrigerate medicines, and clinics chip away at debts incurred from running generators. Yet despite these residual effects from last year's devastating hurricanes, Puerto Rico is moving ahead with major cuts to its health care safety net that will affect more than a million of its poorest residents.

Surgeon, author and checklist-evangelist Atul Gawande has been picked to lead the health care venture formed by online giant Amazon, conglomerate Berkshire Hathaway and banking juggernaut JPMorgan.

It's an interesting choice.

Gawande, a general and endocrine surgeon at Brigham and Women's Hospital in Boston, is probably best known for his work writing about health care for The New Yorker and in books that include the influential Checklist Manifesto.

Ryan Caron King / Connecticut Public Radio

Late last week, the Department of Justice announced it would not defend the Affordable Care Act in a lawsuit filed by 20 conservative state attorneys general.

Miriam Engel / The Hartford Symphony Orchestra

Members of the Hartford Symphony Orchestra ventured outdoors earlier this week to perform a free concert in Hartford's Asylum Hill neighborhood.

On this sunny, spring lunch hour in Hartford, the HSO's Jazz Quartet ripped into a bunch of standards, including "Blues Inn” by Hartford's own Jackie McLean. Almost on cue, people began milling into The Hartford's Liam E. McGee Memorial Park - employees of The Hartford with their Styrofoam box lunches, grade school students in their school uniforms, and people from the neighborhood drawn by the music.

Frankie Graziano / Connecticut Public Radio

The Connecticut Insurance Department has activated its emergency adjuster program following Tuesday’s powerful storms. This will allow insurance companies to bring out-of-state adjusters to help expedite claims.

Updated at 1:30 p.m. ET

Health insurance giant Cigna is buying Express Scripts, the company that administers prescription drug insurance plans for millions of Americans, in a deal worth $67 billion, including $15 billion in Express Scripts' debt.

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