Mirror, Mirror 2024 is your opportunity to explore the impact of policy choices on health and well-being across 10 countries, including the U.S. Read the report here.
Americans’ Views on Health Insurance at the End of a Turbulent Year
Thirty-six percent of Americans who have health coverage through the Affordable Care Act's (ACA) marketplaces and 27 percent of people with Medicaid are pessimistic they will be able to keep their coverage in the future, according to a new Commonwealth Fund survey. Nearly half cite actions by the Trump administration or Congress to undermine the law as the main source of their concern. In a companion To the Point post, Sara R. Collins, Munira Z. Gunja, Michelle M. Doty, and Herman Bhupal highlight federal and state policy options that would increase coverage, improve affordability, and ease consumer concerns.
Is the U.S. Still Trending Toward Expanded Health Coverage?
The history of health care reform in America reflects a dynamic interaction between the two political parties, write James Morone and David Blumenthal, M.D., in the new issue of Health Affairs. Republicans oppose Democratic plans emphasizing public insurance, countering with plans that instead rely heavily on private markets. The next wave of Democratic proposals then absorbs some elements of the latest Republican proposal, and the cycle continues.But the authors say that the assault on the ACA suggests this pattern has been broken.
Health Insurance Markets Perform Better in States That Run Their Own Marketplaces
The individual insurance market is healthier in the 17 states that run their own marketplaces than in states that rely on the federal marketplace, say Mark A. Hall and Michael J. McCue in a To the Point post.
What Happens to Competition and Premiums in States with Just One Marketplace Insurer?
In 2017, there were five states where only one insurer participated in the health care marketplace: Alabama, Alaska, Oklahoma, South Carolina, and Wyoming. Analysts with NORC at the University of Chicago examine what that has meant for these states.
Innovation in Medicaid Managed Care: Insights from Plan Leaders in Expansion States
The Medicaid expansion created an opportunity for managed care organizations to undertake the large-scale changes needed to improve the quality and efficiency of care for increasingly diverse populations. George Washington University’s Sara Rosenbaum and colleagues interviewed leaders of 17 Medicaid managed care plans in 10 states to learn about their experiences as they implement innovations in patient care and provider payment.
Interactive Map: Medicaid Expansion and Work Requirement Waivers
Use our new interactive map to see which states have and have not expanded Medicaid and what the impact of those decisions has been. You can also track the status of states’ waivers to require Medicaid beneficiaries to work or risk losing their benefits.
Bipartisan Deal Takes Important Step to Control Medicaid Drug Prices, But More Is Needed
In a post on To the Point, former congressman Henry Waxman and colleagues Bill Corr and Kristi Martin explain how the Bipartisan Budget Act of 2018 ensures that manufacturers of brand-name drugs cannot take advantage of inappropriately low Medicaid rebates. The deal also includes two other provisions that should save Medicare beneficiaries and the federal government money.
How the Tax Law's Impact on Medicare and Medicaid Could Affect Seniors
Annual Medicare spending is expected to double over the next 10 years, while Medicaid, which provides coverage to more than 4.6 million low-income seniors, will also see greater demand for care. In the latest episode of New Directions in Health Care: The Commonwealth Fund Podcast, producer Sandy Hausman talks with the Commonwealth Fund’s Shawn Bishop and Eric Schneider, M.D., about the new tax law’s potential effect on these already inadequately funded public insurance programs. The tax cuts are expected to add about $1.5 trillion to the federal deficit.
Study Indicates Medicare Spending on Health Services Is Closely Linked to How Care Is Delivered and Paid For
Research has shown that growth in health care spending often has more to do with how much, and what type, of care patients receive than with changes in health status or disease prevalence. With Medicare spending on hospital, postacute, and physician services growing at historically low rates, a Commonwealth Fund–supported study (Health Services Research, Mar. 6, 2018) led by Vanderbilt University Medical Center Laura M. Koehane sought to find out if this still holds true.
Health Affairs Post: Proposed Reforms to the 340B Drub Discount Program
On the Health Affairs Blog (March 7, 2018), Commonwealth Fund–supported researcher Rena M. Conti and colleagues discuss proposed reforms to the 340B drug discount program, which allows hospitals serving disproportionately large numbers of Medicaid and low-income Medicare patients, along with affiliated clinics and pharmacies, to purchase outpatient drugs at deep discounts. Critics say not all participants are using the program, which has grown substantially in recent years, for its intended purpose: improving access to care for low-income patients.
The High Health Toll of Social Isolation — and What Providers Can Do to Help
Most patients don’t get a call from the doctor’s office inquiring about their Thanksgiving plans. But that’s exactly how one health care system is addressing a clear threat to patients’ health — social isolation. In a post to the Wall Street Journal blog“The Experts” (subscription only), Commonwealth Fund President David Blumenthal, M.D., explains that social isolation among older adults can worsen their health.
For Those with Chronic and Behavioral Health Conditions, Lower Income Means Higher Health Costs
People with depression, substance abuse problems, or other behavioral health issues also often have chronic physical health conditions like obesity, hypertension, or diabetes. And having both types of problems is far more common among those with low incomes. Now a Commonwealth Fund–supported study in Medical Care finds that hospital and emergency care spending is much higher for low-income people with these co-occurring conditions than it is for their higher-income counterparts.
The Institute for Healthcare Improvement’s Better Care Playbook — supported by The Commonwealth and four other foundations — offers a wealth of information on the most effective ways to care for people with complex health and social needs. Recent updates describe:
Trump Administration Reins in Idaho’s Move to Ignore ACA
Last week the Trump administration told Idaho that the state cannot move forward with its proposal to create “state-based health benefit plans” that do not comply with ACA regulations. As explained in a recent post by Washington and Lee University’s Timothy Jost, Idaho’s plans would not have covered essential health benefits and could have imposed annual limits on coverage.
What Is Really Driving High Prescription Drug Costs and What Can Congress and the Administration Do to Rein Them In?
It's widely understood that prescription drug costs in the United States are too high. But what’s behind the high prices, and how could Congress and the administration take on drug pricing in the current environment? The Commonwealth Fund recently convened three experts to address these questions in an informational briefing. Read the transcript or listen to the recording to learn more.
