It's clear that both the federal and state results of last week's election will have important consequences for health care. In a new post on To the Point, the Commonwealth Fund's Donald Moulds, Sara Collins, Rachel Nuzum, Akeiisa Coleman, and Shawn Bishop review what we should expect in 2019.

Four states have received federal approval to impose work requirements on Medicaid beneficiaries, and additional states are seeking to do so. But do work requirements prompt low-income adults to find jobs, or are they designed to sanction beneficiaries in a bid to lower Medicaid caseloads? That is the question posed in a new Commonwealth Fund report by Leighton Ku and colleagues at George Washington University.

Also see a recent To the Point post examining the likely impact on hospitals in Kentucky if that state’s pending Medicaid work requirement waiver is approved, as well as two other posts exploring the effects of Arkansas’s work requirements on beneficiaries and federal funds flowing to the state.

New federal guidance describes the Trump administration's plan to support states that are seeking to regulate and subsidize insurance in ways that are very different from those established by the Affordable Care Act (ACA). Timothy S. Jost breaks it down in a new post.

Consumers buying marketplace coverage during this open enrollment season will face a complicated shopping experience. Products marketed as lower-cost alternatives come with a catch: many offer far less coverage, as Georgetown University’s Dania Palanker, JoAnn Volk, and Kevin Lucia explain in a new post.

Commonwealth Fund President David Blumenthal, M.D., weighs in on the growth of bare-bones health plans in a new column for The Hill. "This moves us backward in a health care system that already puts people who get sick, especially those who get very sick, on shaky ground,” he writes.

As purchasers of one-third of all health care provided for U.S. families, employers have had some success in controlling health care costs by shifting costs to employees through high-deductible health care plans. But as the Commonwealth Fund's David Blumenthal, M.D., Lovisa Gustafsson, and Shawn Bishop note in Harvard Business Review, this strategy may have reached its limit — and there are better options available.

Allowing insurance companies to exclude preexisting conditions from health insurance coverage could cost consumers with illnesses like asthma, arthritis, cancer, diabetes, and high blood pressure thousands of dollars in increased out-of-pocket costs, according to a Commonwealth Fund report by Sherry Glied and Adlan Jackson of New York University.

In a related post, the Commonwealth Fund's Sara Collins explains that some Republican proposals, such as the Ensuring Coverage for Patients with Pre-Existing Conditions Act, would erode ACA protections. Even thought the bill would prevent insurers from refusing to sell a plan to people with preexisting conditions or charging higher premium, it would allow them to entirely exclude coverage for care pertaining to the preexisting conditions themselves.

Open enrollment for the ACA's health insurance marketplaces for 2019 started this month. Check out these resources to help:

• A video on what you need to know as the open enrollment period begins
• A new post on states leaning in as the federal government cuts back on outreach, and an article on how cuts to the outreach budget might make it harder for people to enroll
• A primer on short-term health plan gaps and limits that leave people at risk
• An analysis from Timothy Jost on how the federal government will allow states to use the 1332 state waiver program to undermine the ACA
• An interactive map showing what your state is doing about access to comprehensive health insurance.

When Americans talk about the Canadian health system, they often bring up wait times. But how long do Canadians really have to wait to get care? In the latest episode of The Dose, host Shanoor Seervai talks to a chief medical information officer in Canada about wait times and more.

In a new post on To the Point, the Commonwealth Fund's Corinne Lewis, Yaphet Getachew, and Mekdes Tsega say that if the federal government decides to redefine gender as sex at birth, the change could effectively eliminate the ACA's federal protections for transgender people. "The move could have devastating implications for the health and health care of transgender and gender nonconforming individuals, placing an already vulnerable population at even greater risk," the authors say.

The latest issue of our international newsletter covers the European Union’s new three-year initiative on health equity; National Health Service England’s plans to introduce a system for monitoring medication errors; and a Swiss government proposal to have employers pay family caregivers during short work absences.

The Commonwealth Fund is seeking strong candidates for two open positions: Assistant Vice President, Administration, and Vice President, Outreach and Strategy. The Assistant Vice President, Administration, is a multifaceted position that will provide overall direction for human resources and building management. Based in New York City, the individual will have oversight for recruitment, benefits, and training as well as responsibility for maintaining Harkness House, a turn-of-the century townhouse, as a landmark building and a functional work environment.

The Vice President, Outreach and Strategy, is a member of the Communications Department leadership team. Also based in New York City, this individual will have responsibility for planning and executing the Commonwealth Fund's dissemination activities. These include: traditional media relations, strategic communications planning, social media integration, strategic positioning, staff media training, and more.

On Friday, November 16, please join a Health Affairs forum supported by the Commonwealth Fund and the Century Foundation at the National Press Club in Washington, D.C. Presenters will discuss two Health Affairs papers published that day that examine key elements of potential health reform policies that may be a part of Democratic and Republican candidates' proposals in the 2020 election.