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The Connection: Americans Are Paying More for Employer Health Coverage; Threats to the Small-Group Market; and More

The Commonwealth Fund Connection What's new

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Americans Are Paying More for Employer Health Coverage

U.S. workers and their families, especially those living in the South, are spending a bigger share of their income on health care. According to a Commonwealth Fund study, average employee premium contributions for single and family plans consumed nearly 7 percent of U.S. median income in 2017, up from 5 percent in 2008. In Louisiana, premium contributions represented 10.2 percent of median income. For Americans whose incomes fall in the midrange of the income distribution, total spending on employer plan premiums and potential out-of-pocket costs to meet deductibles amounted to 11.7 percent of income last year, up from 7.8 percent a decade earlier.

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Policymakers must address rising #healthcare costs. Doing so will be critical for keeping down the rising employer premiums and deductibles that are a growing burden for middle-income families.

Commonwealthfnd https://buff.ly/2UnZbm6 Health Insurance Coverage and Access

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Jost: Court Decision to Invalidate the Affordable Care Act Would Affect Every American

On Friday, Texas federal court Judge Reed O'Connor delivered a judgment purporting to accomplish what Republicans in Congress had failed to do and what the Supreme Court had twice refused to do: invalidate the Affordable Care Act. Legal expert Timothy S. Jost explains in a new To the Point post why "the logic of Judge O'Connor's decision is simple and straightforward, but clearly wrong.”

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Waivers Would Radically Restructure Coverage

The Centers for Medicare and Medicaid Services recently outlined how states could use Section 1332 of the Affordable Care Act in ways that could undermine the law. On To the Point, legal expert Timothy S. Jost discusses the four waiver concepts the administration put forward to restructure health coverage, including allowing states to use federal funds for subsidies to pay for health plans that aren't compliant with the health care law.

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Medicaid Work Requirements: States' Actions, and Inaction, Are Putting People's Coverage at Risk

"With thousands in Arkansas losing their Medicaid benefits under the state's work-requirement demonstration, the importance of evaluating such experiments could not be clearer," say George Washington University's Sara Rosenbaum and colleagues. But as the authors report in a Commonwealth Fund issue brief, the nation's first-ever Medicaid work demonstration is proceeding despite the absence of any federally approved evaluation to test the requirements' impact on people, as called for under Section 1115 of the Social Security Act.

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Few Differences in Market Participation Before and After Affordable Care Act

When the Affordable Care Act and its consumer protections became law, insurers feared that people enrolling in marketplace plans would generally be less healthy than people who chose not to enroll. But an analysis by Sherry Glied and Adlan Jackson of New York University finds few differences in individual-insurance market participation before and after the law took hold.

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Association Health Plans Could Harm Small-Group Market

A recent federal rule has paved the way for many more small firms and self-employed individuals to purchase insurance through association health plans, which are not subject to preexisting-condition protections and other Affordable Care Act regulations. To estimate the potential impact of these health plans, Wake Forest University's Mark A. Hall and Virginia Commonwealth University's Michael J. McCue analyzed how "market segmentation" has functioned in the small-group market to date.

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Delivery System Reform

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Listen to The Dose: What It Means to Be Sick

On the latest episode of The Dose podcast, host Shanoor Seervai talks about a recent "Health Care in America" survey on the experiences of 1,500 patients who have had two or more hospital stays and visits with three or more doctors in the past three years. Survey codirectors Robert Blendon, a professor of health policy at the Harvard T.H. Chan School of Public Health, and Eric Schneider, M.D., senior vice president for policy and research at the Commonwealth Fund, discuss the findings.

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Newsletter Article

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Physicians Are Unhappy with Electronic Health Records: How Can We Fix Them?

It's no secret that many physicians are unhappy with their electronic health records (EHRs), says Commonwealth Fund President David Blumenthal, M.D. As Blumenthal points out on To the Point, EHRs really have one critical performance requirement in our current fee-for-service health system: generating clinical revenues. What they don't do so well is support the things that physicians, patients, and policymakers value, including better care experiences, reduced costs, and population health management.

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Why Do Primary Care Physicians for Low-Income Patients Love Their Jobs?

The stories of primary care doctors who care for low-income people — about the pride and joy they derive from their work, despite obstacles in meeting patients' needs — is the focus of a new Commonwealth Fund feature article. The doctors say that the opportunity to provide emotional support enables them to make a difference in their patients' lives. 

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New on the “Better Care Playbook”

In honor of the second anniversary of the Better Care Playbook’s launch, Jay Want, M.D., executive director of the Peterson Center on Healthcare, reflects on the philosophy behind the Playbook and his vision of how organizations can use its information and innovative models to improve care for patients with complex needs.

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The Connection: Americans Are Paying More for Employer Health Coverage; Threats to the Small-Group Market; and More