Imposing work requirements on Medicaid beneficiaries will likely disrupt health care for as many as 118,000 low-income Americans, leaving them exposed to potentially catastrophic medical costs, a Commonwealth Fund study by Sara Collins, Sherry Glied, and Adlan Jackson finds. That projection is double the number who would normally be expected to disenroll from Medicaid over a two-year period because of fluctuations in income, administrative barriers, or life changes.

The U.S. health care system is leaving many of the sickest Americans feeling helpless, facing serious problems with their care, and struggling to make ends meet, according to the first joint survey from the Commonwealth Fund, the New York Times, and the Harvard T.H. Chan School of Public Health, part of a partnership called Health Care in America. The survey’s initial findings reveal that Americans who become seriously ill often feel confused and helpless (62%), experience major problems with their care (61%), or face the risk of financial ruin (53%) — even when they have health insurance.

"The goal of this survey partnership is to open a window into what it's like for our sickest family members, friends, and neighbors," said Commonwealth Fund President David Blumenthal, M.D., who discusses the new project on the Fund's To the Point blog.

The U.S. Department of Health and Human Services (HHS) has announced it will test a new payment model that aims to substantially lower the cost of prescription drugs and biologics covered under the Medicare Part B program. The new system would, for the first time, base payment for these drugs on the typically lower drug prices paid in other countries. On To the Point, the Commonwealth Fund's Shawn Bishop, Christina Ramsay, and Lovisa Gustafsson argue that HHS could instead pursue a broader cost-reduction strategy that adapts core elements of the international approach to drug pricing.

The Trump administration recently proposed a "public charge" rule that would place greater emphasis on immigrants' receipt of public benefits in determining admissions to the U.S. and eligibility for green cards. George Washington University's Sara Rosenbaum explains that the proposed rule could discourage millions of legal immigrants from enrolling in Medicaid.

A proposal to limit beneficiaries' costs for traditional Medicare's core services and reduce the need for supplemental coverage is the focus of a Commonwealth Fund report by Cathy Schoen, Karen Davis, Christine Buttorff, and Amber Willink. The researchers propose capping annual out-of-pocket expenses for Parts A and B benefits and replacing hospital cost-sharing with a per admission copayment — reforms, the authors say, that would put traditional Medicare on a more equal footing with private Medicare Advantage plans.

On Thursday, November 1, the Affordable Care Act's (ACA) insurance marketplaces will launch their sixth enrollment season. How easily you can access information about ACA coverage options and get personalized help with enrollment will depend on where you live. The federal government has cut back on funding for ACA outreach, but many states that operate their own marketplaces have invested in advertising and assistance, write Georgetown University's Sabrina Corlette and Rachel Schwab.

Substantially more small-business owners and their workers have health coverage today than before the ACA, mainly because of the subsidized coverage options and Medicaid expansion, new Commonwealth Fund-supported research shows. The analysis, by Mark Hall of Wake Forest University and Michael McCue of Virginia Commonwealth University, also finds that premium and claim costs have remained stable in the small-group market.

Over the past year, new health coverage products not subject to the ACA's consumer protections have hit the individual market. In a To the Point post, Maanasa Kona, Kevin Lucia, and Sabrina Corlette of Georgetown University's Center on Health Insurance Reforms focus on direct primary care arrangements.

In a new post on the Wall Street Journal's "Experts" blog (subscription required), Commonwealth Fund President David Blumenthal, M.D., points to health plans that have found significant savings by providing medically tailored meals to enrollees with chronic illness. The recently passed Chronic Care Act makes it possible for Medicare programs to invest in food services.

In the American Journal of Managed Care, Commonwealth Fund–supported researchers led by Stephen M. Shortell, M.D., of the UC Berkeley School of Public Health report that physician practices opting to join Medicare ACO programs in 2012 had greater capabilities to manage risk and succeed under a value-based payment model than practices that did not.

Get your ticket today for Putting Care at the Center 2018, the central event for the emerging field of complex care. Join the National Center for Complex Health and Social Needs, Rush University Medical Center, and the Robert Wood Johnson Foundation in Chicago on December 5–7 to meet, network, and learn with over 600 other people working to improve care for people with complex health and social needs across the country. CEUs available for social workers, nurses, and physicians. Early bird registration open now: https://www.centering.care/.

Join a webinar hosted by the Institute for Healthcare Improvement, the Commonwealth Fund, and five other foundations partnering to improve care for patients with complex needs on Tuesday, October 30, 1:30–2:30 p.m., EST. The webinar will explore the business case for managing patients with complex health and social needs; start-up and long-term costs; and promising practices to finance complex care models.

Participating experts include: Ken Coburn, Health Quality Partners; Carolyn Ingram, Molina Healthcare, Inc.; David Pryor, Ascension Health; and Kedar Mate, Institute for Healthcare Improvement. Register today.