Millions of people in the U.S. live without health insurance, a circumstance that can cause people to weigh the need to see a doctor against the cost. Unfortunately, many people will put off or do without medical care because they can’t afford it, a decision that could jeopardize their health.

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While the Affordable Care Act has boosted the number of Americans with insurance, millions remain uninsured. In 2018, 27.5 million people – more than 8% of the U.S. population – were uninsured, according to the U.S. Census Bureau. Private health insurance covered 67% of Americans. Those without health coverage face the dilemma: Where can I go for medical care without insurance?

The Coverage Gap

In addition to the people who are uninsured, millions are underinsured, according to a survey by the Commonwealth Fund. Among people with health insurance, 29% were underinsured in 2018, compared to 23% in 2014, according to the fund’s Biennial Health Insurance Survey: “People who are ‘underinsured’ have high health plan deductibles and out-of-pocket medical expenses relative to their income and are more likely to struggle paying medical bills or to skip care because of cost.”

The survey found that 41% of underinsured adults reported they delayed needed medical care because of cost. By contrast, 23% of people with adequate insurance coverage said they delayed such treatment. Also, 47% of underinsured adults reported medical bill and debt problems.

Tips for Finding Affordable Medical Care

If you’re uninsured or underinsured, here are eight strategies for finding affordable medical care:

1. Research your eligibility for insurance.

Depending on your situation, you might be eligible to buy individual health insurance coverage from the ACA marketplace or in the individual market, or you might qualify for Medicaid, Medicare or the Children’s Health Insurance Program for your kids, says Kim

Proposition 118 would create a statewide paid family and medical leave program for workers who’ve earned at least $2,500. The program would allow workers to take up to 12 weeks of leave in most cases, and 16 weeks in the event of pregnancy or childbirth complications. Payments would come from a state-run insurance fund. In workplaces with 10 people or more, workers and employers would each contribute to the fund — at a rate of 0.9% of an employee’s wages — but employers in workplaces of nine or fewer people would be exempt from having to contribute to the premium. Companies with their own programs that meet criteria could opt out.

The case for: Paid family and medical leave would allow workers to stay at home longer with their newborns, care for loved ones in need, or simply prioritize their own health. Without paid leave, workers are often under pressure to return to work more quickly or not to take time off at all. Research has shown that paid leave programs expand employment opportunities and contribute positively to the state economy.

The case against: Workers would be forced to pay into a program that they may never need. That may be especially problematic in a recession, as many individuals and families are having a harder time covering their expenses. Many businesses are struggling, too, and Proposition 118 would add another cost during an uncertain time. Depending on how much the program generates, premium rates may be raised from 0.9% to 1.2%. And while the ballot measure allows certain businesses to opt out, doing so may be complicated and expensive.

Ballot question: “Shall there be a change to the Colorado Revised Statutes concerning the creation of a paid family and medical leave program in Colorado, and, in connection

DALLAS, Oct. 6, 2020 /PRNewswire/ — Witherite Law Group, a leading personal injury law firm with locations in Dallas, Fort Worth and Atlanta, Georgia announced today that Elisabeth “Lis” Buchanan, a Board Certified Nurse Practitioner, has joined their team as a medical and client treatment in-house consultant to provide expertise in helping guide the medical treatment of their personal injury clients.

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Buchanan will review and analyze case management and medical records and advise the firm’s pre-litigation and litigation teams on the best treatment options to ensure clients get proper medical evaluations and treatment for their injuries. Buchanan will also help educate the firm’s lawyers and case managers as it relates to fully understanding and explaining the medical aspects of cases to insurance adjustors, opposing counsel and jurors.

A nationally Board Certified Nurse Practitioner, Buchanan also holds a Doctorate in clinical practice and a Masters in Healthcare Administration with over 30 years of experience in healthcare and litigation support for discovery, depositions, and an expert witness for jury trials.

In joining the car and truck accident firm, Buchanan stated, “Throughout my career, I’ve strived to be inspirational, innovative and influential in using my expertise as a clinician. I look forward to doing this in support of our clients to ensure they get the quality care they need and help them recover from their car or truck accident injuries as quickly as possible.”

Amy Witherite, truck accident attorney and founding partner stated, “It’s not uncommon for a health insurance company to employ a Patient Care Coordinator. And law firms do sometimes employ nurses. However, those nurses are generally limited to reading records and doing chronologies. We’re demonstrating our ‘People First, You Matter’ philosophy by structuring Lis’ role to help coordinate care with the doctors and therapists and ensure



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Surprise medical billing is one of the most urgent topics in health care.

Too often after a hospital procedure or visit to an emergency room patients get hit with unexpected bills from out-of-network doctors they had no role in choosing. These include assistant surgeons, emergency room doctors and anesthesiologists.

Most research and media coverage focuses on how burdensome these bills are for the patients who receive them. As health economists and policy analysts, we think there is a broader impact of surprise billing that deserves to share the spotlight.

Evidence from our recent study suggests that everyone with commercial health insurance is paying higher premiums today because lawmakers allow the practice of surprise billing to persist. Fixing surprise billing won’t just help the patients being billed; it offers the potential to lower health insurance premiums for everyone.

Patients can typically choose their doctors before they get treated. For example, they might pick a primary care doctor or the hospital and surgeon for a planned procedure based on reputation and whether those providers are in their insurance network. Picking a doctor who is in their insurance provider’s network typically comes with lower costs for the patient.

When the system works well, a patient ends up with a provider they like at a price negotiated by their insurer.

But patients don’t always have the opportunity to make this informed choice. In an emergency, a patient accepts the ambulance that arrives on the scene and the physicians who treat them in the emergency room. For elective procedures, even though the patient chooses the hospital and lead surgeon, they do not choose the radiologists, pathologists and anesthesiologists who are integral to their care.

About one in five commercially insured patients treated at an in-network emergency room is seen

The players are accused of submitting false reimbursement claims for rehabilitation therapy by a Houston trainer, according to the Harris County DA.

HOUSTON — Eight former NFL players and a Houston athletic trainer have been indicted in a scheme to defraud an NFL player trust fund by submitting false claims for medical benefits, Harris County District Attorney Kim Ogg announced Monday.

Two of them, Corey Bradford and Shantee Orr, were Houston Texans and Jonathan Hadnot, Jr played college football at the University of Houston.

The claims were for rehabilitation by a trainer named Louis Ray, the owner of Rehab Express in the Galleria area.

Ray, 59, was indicted for the first-degree felony of Securing the Execution of a Document by Deception, for allegedly taking checks valued at more than $300,000. He surrendered Monday.

Prosecutors say Ray created fraudulent invoices claiming he performed treatments on players from March 7, 2016 to November 2018. The players would then sign and submit forms to be reimbursed by the Gene Upshaw NFL Player Plan, a health-reimbursement account. The players are accused of pocketing the reimbursement money and paying Ray for signing and verifying the fake invoices.

Medical records show that 92 claims were submitted claiming reimbursements totaling $723,826 with Ray allegedly receiving payments totaling $112,972.

“Health insurance scams are insidious because that kind of fraud leads to higher premiums for everyone else,” Watson said. “Not only does it increase the rates, but it costs a lot of taxpayer money to investigate these.”

Former NFL players indicted

  • Corey Bradford: indicted for the second-degree felony of Securing the Execution of a Document by Deception, for allegedly taking checks valued at more than $150,000 and less than $300,000. Bradford 44,  was a wide receiver with the Houston Texans from 2002-2005.
  • Shantee Orr: indicted for