How the Health Care of U.S. Women Compares Internationally
Women in the United States face significantly worse health outcomes and access to care than those in other countries, with notable access disparities among Black and Hispanic women, a new Commonwealth Fund study finds. The report reveals how the U.S. performs against other countries across a variety of critical measures for women such as life expectancy, avoidable deaths, rates of illness, and mental health. Despite the discouraging data, the report notes policymakers have several options that could greatly improve women’s health and health care in the U.S.
Insured Americans Face Unexpected Medical Bills, Coverage Denials
Even with health insurance, many working-age Americans face significant challenges navigating the health care system. According to a new Commonwealth Fund survey, in the past year 45 percent of insured, working-age adults received a medical bill or copayment for a service they thought should have been covered by their insurance, 17 percent were denied coverage for a doctor-recommended service, and nearly 60 percent said that coverage denials led to delayed care. The authors note several areas where policy interventions could improve consumer protection.
What’s at Stake in the 2024 Election for Women’s Health?
In the U.S., a woman’s access to essential health care — including abortion and other reproductive health services — largely depends on where she lives. The state she lives in determines how likely she is to have a healthy pregnancy and safe delivery, as well as her risk of dying from preventable causes like substance use and certain cancers. The outcome of the 2024 election could further fracture or improve the landscape of women’s health care. In a new explainer, Commonwealth Fund researchers examine the potential impact of the election on coverage, access to women’s health care, women’s health disparities, and more.
Health Centers Are Resilient in Face of Rising Challenges
Community health centers, or CHCs, are the backbone of America’s health care safety net, providing accessible, comprehensive, and coordinated health care to more than 30 million patients a year. Yet a new Commonwealth Fund survey shows that more than 70 percent of health centers report worsening workface shortages that threaten their ability to continue providing high-quality care. Additional challenges include rising mental health and substance use treatment needs, changes in Medicaid enrollment, and persistent funding gaps. But the findings also show that CHCs are managing to do more with less.
Since September 2023, how many states have implemented protections for people who have medical debt or pursued buying and forgiving medical debt?
6 states
12 states
24 states
48 states
Scroll down to see if you got it right.
What Patients, Providers Say About Medicare Drug Costs
Many Medicare beneficiaries worry about how they will pay for their prescription drugs. Some resort to skipping doses, or not filling prescriptions at all. On To the Point, researchers from Arnold Ventures, PerryUndem, and the Commonwealth Fund report on how Medicare beneficiaries are dealing with high drug costs. Their providers, meanwhile, say that although cost is a factor driving medication noncompliance, many are unsure how to address affordability issues with their patients.
Although having a Medigap supplemental insurance policy can make traditional Medicare more affordable for beneficiaries, these policies don’t protect consumers against discrimination. As a result, Medigap insurers can set higher premiums for older adults, deny coverage based on someone’s medical history, or engage in other discriminatory actions. Researchers from the Medicare Rights Center explain how a new federal rule could correct this issue by applying consumer protections to certain companies that sell Medigap policies. But the authors say that state-level or congressional action is needed to bolster rights for enrollees in all Medigap plans.
How States Are Enforcing the Mental Health Parity Law
The Mental Health Parity and Addiction Equity Act requires that insurance coverage for mental health and substance use disorders provide a level of financial protection similar to coverage for other health conditions. But many health insurers have yet to fully comply, in part because of the law’s complexity. In a new Commonwealth Fund brief, Georgetown University’s JoAnn Volk and Emma Walsh-Alker and attorney Christina Goe report that some states are refining their approaches to ensuring compliance, combining longstanding tools for enforcing coverage standards with newer strategies tailored to the federal law.
A special two-part edition of The Dose podcast brings listeners along to an exhilarating gathering of health care’s most innovative thinkers and changemakers — Aspen Ideas: Health. In part 1, host Joel Bervell speaks with two people dedicated to supporting communities that have been excluded from our health care system: Lola Adedokun, executive director of the Aspen Global Innovative Group at the Aspen Institute and leader of the Healthy Communities Fellowship; and Elizabeth Lutz, executive director of the Health Collaborative in San Antonio, Texas.
In part 2, Bervell talks with two people who are reshaping how we think about community health: Mary Oxendine, a Lumbee and Tuscarora woman and the former North Carolina Food Security Coordinator in Durham County; and Shameca Brown, a mental health provider and advocate for Black and brown people in Tulsa, Oklahoma, and former member of the Mental Health Association of Oklahoma’s board of directors.
Street Medicine Helps with Challenges of Homelessness
More than 650,000 people were homeless in the U.S. in 2023 — the highest number since the federal government started tracking these data. Forty percent are unsheltered, meaning they live in places like parks or abandoned buildings. Most face significant health challenges, and our health system has historically failed to meet their needs. On To the Point, the Commonwealth Fund’s Sara Federman and Akeiisa Coleman discuss street medicine programs that address this problem by bringing care to people where they are.
Climate Change and the Health of Noncitizen Workers
Climate change threatens to upend worker safety and health, with noncitizen workers at a disproportionate risk. The Urban Institute’s Dulce Gonzalez describes the challenges facing this population — jobs that expose people to climate risk, like agriculture or construction; a fear of reporting workplace violations; language barriers; and a lack of access to health insurance. Moving forward, expanding and enforcing existing federal worker protections will be important, as will addressing barriers to care and insurance, the author writes.
At the end of its most recent term, the Supreme Court cast aside the “Chevron deference,” which for 40 years required judges to defer to reasonable interpretations by federal agencies of the laws they are charged with administering. In an opinion piece in STAT, former Commonwealth Fund President David Blumenthal, M.D., and Sara Rosenbaum, J.D., Harold and Jane Hirsh Professor Emerita of Health Law and Policy at the Milken Institute School of Public Health, George Washington University, say that for Congress to legislate effectively without Chevron, it will need help enacting laws that leave far less room for interpretation, especially when it comes to highly technical and complex issues.
Funders Can Promote Diversity in the Nonprofit Sector
In 2020, the Commonwealth Fund set out to understand its role as a grantmaking organization in fostering diversity in the foundation sector. On To the Point, Commonwealth Fund President Joseph R. Betancourt, M.D., and Grants Associate Julian Scott report on the Fund’s efforts to partner with more racially and ethnically diverse grantees, younger grantees, and grantees with disabilities. Although the Fund has made progress, the authors acknowledge that more needs to be done. “To build a bench of partners that will help us better understand and address the health care challenges facing people here and abroad, this effort must be deliberate and sustained over time,” they write.
The Pozen-Commonwealth Fund Fellowship in Health Equity Leadership at Yale University — a program aimed at helping health care professionals develop the leadership skills and deep understanding of teams, markets, and organizations necessary to tackle major inequities in the U.S. health care system — has announced its newest cohort of fellows. They are: Akshar Abbott, M.D., a Veterans Administration ophthalmologist; Liany Arroyo, COO of the Charter Oak Health Center in Connecticut; and Carrie Bridges, vice president of community health and equity at Lifespan Health System in Rhode Island.
Promoting Public Health
This month, U.S. News and World Report declared Falls Church, Virginia, to be the healthiest community in the nation, based on a host of metrics, including residents’ proximity to parks and grocery stores. Transforming Care described strategies that coalitions in less affluent communities are using to promote public health, including increasing access to transportation and safe housing.
QUIZ: Answer
The answer is B: 12 states took legislative action related to protecting consumers with medical debt between September 2023 and July 2024.
On To the Point, Georgetown University’s Maanasa Kona highlights these state actions, including: New York requiring hospitals to make financial assistance available to more patients and banning discrimination based on immigration status; Delaware and Maine prohibiting creditors from charging interest on medical debt; and Florida and Virginia barring medical debt collection lawsuits unless they’re initiated within three years of the debt becoming due.
Affordable, quality health care. For everyone.
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