The Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.

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December 11, 2023

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Millions Lose Coverage Amid Medicaid’s Unwinding

Millions of children and adults have lost their Medicaid coverage since May as states began redetermining people’s eligibility for the program. Rates of disenrollment for procedural reasons, like failing to return forms or using an inaccurate mailing address, are high. On To the Point, health policy experts Sara Rosenbaum and MaryBeth Musumeci say that although the federal government and advocates have begun to take action to mitigate erroneous disenrollments, Medicaid’s structural limitations, including the program’s restrictive eligibility limits, need to be addressed as well.

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Medicare Drug Pricing Reforms and State Budgets

Thanks to the Inflation Reduction Act, Medicare now has the power to bargain with drug manufacturers on prices for selected prescription drugs. The 2022 law also requires pharmaceutical companies to pay Medicare back for increases to list prices that exceed inflation. And because list prices are set for the entire U.S. drug market, these changes will be felt beyond Medicare. On To the Point, Anna Kaltenboeck explores how lower prescription drug prices will help state budgets, increase tax revenue, and improve affordability for consumers.

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FEATURED CHART

Gun Violence: A Public Health Crisis

In the United States, gun violence leads to roughly 30,000 inpatient hospital stays, 50,000 emergency room visits, and more than $1 billion in immediate medical costs every year — a veritable public health crisis. And with most of the associated costs borne by Medicaid and Medicare, it’s American taxpayers who ultimately foot the bill. In our International Insights newsletter, Commonwealth Fund Vice President Reggie Williams explores what the health system can do to help address gun violence, looking abroad for effective policies and programs the U.S. might consider.

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Plan Options as Medicaid Continuous Enrollment Ends

In April, Congress ended the requirement that states allow people to stay on Medicaid continuously, a temporary measure that started during the COVID-19 pandemic. Since then, nearly 12 million people have been disenrolled from coverage. Georgetown University’s Rachel Swindle and Sabrina Corlette explore state and federal efforts to help people transition to Affordable Care Act marketplace plans and limit coverage gaps. These include extended special-enrollment periods to give people longer windows to select marketplace plans and auto-enrollment programs to help people transition to other coverage.

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Expanding State Services for Young People with Autism

Improved screening and greater awareness have led to a dramatic increase in autism spectrum disorder (ASD) diagnoses in young people over the past two decades. But the supports available to youth with ASD haven’t kept pace with the rising need, particularly for the one of three children on the spectrum who live in households with low income. Expert Laura Conrad explains how states can improve Medicaid services for young people with ASD, such as by expanding youth-specific Medicaid autism waivers, helping families understand their coverage and care options, and expanding access to school-based Medicaid services.

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How Clinicians Can Protect Patients and the Planet

At the first United Nations Health Day on December 3, the United States announced commitments by federal health care systems to reduce greenhouse gas emissions, with discussions centered on the role clinicians play in creating environmentally sustainable health care. On To the Point, Hardeep Singh, M.D., of the Michael E. DeBakey VA Medical Center in Houston examines the ethical obligations of physicians, nurses, and other health professionals to reduce health care’s carbon footprint and protect patients from harm, as well as the ways they can influence practice and policy.

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2024 AHCJ International Fellows Named

After a three-year hiatus, the Commonwealth Fund–supported Association of Health Care Journalists International Health Study Fellowship is back for 2024. The new class of fellows is a group of experienced reporters with ambitious project proposals:

- Usha Lee McFarling, STAT: Why Portugal outperforms the U.S. on key health metrics, despite spending less and despite its own issues with racial health disparities and structural racism.
- Avery Martinez, KVIA/ABC-7 El Paso: Mental health stigma — how culture, language, tradition, and medicine interact, from Spain to the U.S.–Mexico border.
- Ariel Cohen, CQ Roll Call: What U.S. presidential candidates pushing for stricter abortion laws can learn from France’s 14-week abortion ban.
- Eleanor Klibanoff, Texas Tribune: What Texas can learn from Italy’s big investment in a small-scale solution to its rural primary care problem.

Reducing Racism in Health Care

In the first of a series documenting the extent and impact of racism and discrimination in the U.S., KFF reported that during medical visits, 60 percent of Black adults, about half of American Indian and Alaska Native and Hispanic adults, and roughly 40 percent of Asian adults say they prepare for possible insults from providers or staff ([link removed] ) or feel they must be very careful about their appearance to ensure fair treatment. Commonwealth Fund researchers describe what health care systems are doing to identify discriminatory practices affecting adults ([link removed] ) as well as children ([link removed] ) .

Affordable, quality health care. For everyone.

The Commonwealth Fund, 1 East 75th Street, New York, NY 10021

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