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A Weekly Health Policy Round Up From Health Affairs
November 8, 2020
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IN THE JOURNAL
NEW ISSUE:
HEALTH SPENDING, MEDICAID & MORE
In addition to the final versions of five papers originally published online, four of which relate to COVID-19, this month’s issue of Health Affairs covers a range of topics, including health spending, Medicaid policy, equity, and global health.
Read the November 2020 table of contents.
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MEDICAID
Trends In State Medicaid Eligibility, Enrollment Rules, And Benefits
By Ashley M. Fox, Wenhui Feng, Jennifer Zeitlin, and Elizabeth A. Howell
This study provides a broader picture of state Medicaid programs beyond Medicaid expansion by comprehensively measuring state Medicaid policy across four dimensions over the period from 2000 to 2016–18. Read More >>
Indiana’s Section 1115 Medicaid Waiver And Interagency Coordination Improve Enrollment For Justice-Involved Adults
By Justin Blackburn, Connor Norwood, Dan Rusyniak, Amy Lewis Gilbert, Jennifer Sullivan, and Nir Menachemi
Providing Medicaid coverage as adults transition from incarceration to living in the community can yield significant health and social benefits. Justin Blackburn and coauthors examine how Indiana combined Medicaid expansion through a Section 1115 waiver with additional policies designed to maximize Medicaid coverage for low-income
justice-involved adults.
Read More >>
CONSIDERING HEALTH SPENDING
Geographic Variation In Medicare Per Capita Spending Narrowed From 2007 To 2017
By Yongkang Zhang and Jing Li
Geographic variation in Medicare spending has long been viewed as evidence of health system inefficiency. With administered pricing, Medicare spending variation reflects different patterns of care that cannot be explained by population health characteristics. Analyzing fee-for-service data between 2007 and 2017, Yongkang Zhang and Jing Li report that the risk- and price-adjusted gap in spending between the highest and lowest-decile hospital referral regions declined by 14 percent. Read More >>
MATERNAL HEALTH
Medicaid Expansion Increased Preconception Health Counseling, Folic Acid Intake, And Postpartum Contraception
By Rebecca Myerson, Samuel Crawford, and Laura R. Wherry
The period before pregnancy is critically important for the health of a woman and her infant, yet not all women have access to health insurance during this time. Rebecca Myerson and coauthors evaluated whether increased access to health
insurance under the Affordable Care Act Medicaid expansions affected ten preconception health indicators. Read More >>
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Less than 24 hours after the final polls closed, Health Affairs' Alan Weil sat down with Kimberly Leonard, senior health care reporter at Business Insider, and Shannon Muchmore, editor at Healthcare Dive, to share his perspective on what the future of health policy may look like when the election is in the rearview mirror.
Listen here.
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THIS WEEK ON THE BLOG
FOLLOWING THE ACAWhat Biden’s Election Would Mean For The Affordable Care Act
By Katie Keith (11/5/20)
In what otherwise appears to be a status quo election, what does a Biden victory mean for the Affordable Care Act? This post attempts a first pass at an answer. Read More
>>Even In 14-Point Text, ‘Buyer Beware’ Is No Organizing Principle For Insurance ReformBy Margaret A. Murray and Heather Foster (11/3/20)Brian Blase and Doug Badger recently attempted to justify a Trump administration regulation that encourages Americans to abandon Affordable Care Act–compliant plans in the Marketplace in favor of short-term limited-duration plans. As lead litigants in a case to stop the administration from inflicting these junk insurance plans on American consumers, we offer the following rebuttal. Read More >>Open Enrollment Begins, New Basic Health Plan MethodologyBy Katie Keith (11/3/20)
Even with all eyes on the 2020 election, the 2021 open enrollment period began in most states on November 1, 2020, and extends through December 15, 2020. This post discusses additional data and resources from the Centers for Medicare and Medicaid Services (CMS) in light of the open enrollment period and a new proposed methodology for the Basic Health Program (BHP) for 2022. Read More >>COVID, Elections, And Health Insurance: What Would Tim Do?By Theodore Marmor and Frances Miller (11/2/20)In
considering what the coronavirus catastrophe could mean for America’s health insurance reform, we ponder how Tim Jost might take the COVID-19 "lemon" and squeeze it into something tasting more like universal coverage "lemonade." What framework would Tim find helpful for addressing this and other questions facing America right now? Read More >>
Georgia Gets Green Light On Waiver To Restructure Individual Market
By Katie Keith (11/2/20)
On November 1, 2020, the Centers for Medicare and Medicaid Services (CMS) and the Department of the Treasury approved Georgia’s waiver under Section 1332 of the Affordable Care Act (ACA). Georgia is now authorized to establish a
state-based reinsurance program and eliminate the use of HealthCare.gov. This is the broadest waiver yet approved under Section 1332. Read More >>
Trump Administration Finalizes Transparency Rule For Health InsurersBy Katie Keith (11/2/20)On October 29, the Departments of Health and Human Services, Treasury, and Labor issued the "transparency in coverage" final rule. The rule imposes new transparency requirements on group health plans and health insurers in the individual and group markets. Under the final rule, plans and insurers must disclose cost-sharing estimates at the request of an enrollee and publicly release negotiated rates for in-network providers, historical out-of-network allowed amounts and billed charges, and drug pricing information. Read More >>
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COVID-19
Universal Testing To End The Pandemic
By Reda Cherif, Fuad Hasanov, and
Michael Mina (11/6/20)
In the face of the COVID-19 pandemic, we urgently need an all-out effort to set up a universal testing infrastructure. The technology to develop rapid, convenient, and cheap tests already exists. Producing these tests at the needed scale can be achieved quickly, and the annual cost would be miniscule compared to the cost of the pandemic. Read More >>
What COVID-19 Exposed In Long-Term Care
By Karen Wolk Feinstein (11/5/20)
We cannot bring back those who have died in skilled nursing facilities during the pandemic, but we can honor them by implementing decisive and needed reforms for nursing facilities, says this author. A bipartisan opportunity now exists for humane reforms. The author, who heads a foundation, also describes its efforts to improve the long-term care system over the decades. Read More >>
The Potential Role Of Open Data In Mitigating The COVID-19 Pandemic: Challenges And Opportunities
By Sunyoung Pyo, Luigi Reggi, and Erika G. Martin (11/2/20)
Investment in the ongoing development and release of open health data about the pandemic has the potential to generate
new solutions from diverse users, start to rebuild public trust in government, and strengthen open-data efforts in the long term. Read More >>
Averting
"Generational Catastrophe": How We Can Safely Reopen Our Schools
By Gregg Bloche, Kenneth Beckman, Daniel Wikler, and Joshua Goodman (11/2/20)
Americans from across the political spectrum believe that it’s urgent that we reopen our schools, both to save our children from devastating effects on their development and to avert a childcare crisis. There’s a path toward doing so without risking thousands of lives, even absent an effective coronavirus vaccine. School districts can make this happen through routine, low-cost testing—if the federal government provides the wherewithal now. Read More >>
PUBLIC HEALTH
Facebook’s Latest Attempt To Address Vaccine Misinformation—And Why It’s Not Enough
By Ana Santos Rutschman (11/5/20)
Facebook’s newest set of measures to combat vaccine misinformation constitutes an improvement over the status quo, but it leaves the sources of the problem largely untouched. As the COVID-19 pandemic has led to an increase in pages that push health misinformation, rethinking current approaches taken by social media platforms toward this problem is imperative. Read More >>
LEGAL & REGULATORY ISSUES
Origins: Our Health Law Casebook And Tim Jost
By Barry R. Furrow, Thomas L. Greaney,
Sandra H. Johnson, and Robert L. Schwartz (11/6/20)
One day over lunch 36 years ago, we original coauthors began to speculate about whether we could create a health law casebook that improved on the current offerings. We decided to collaborate to create an improved model, calling it “Health Law” rather than “Law and Medicine” to emphasize the changing nature of health care delivery by the 1980s. Read More >>
SYSTEMS OF CARE
What US Medicine Needs To Do To Finally Embrace Capitation
By Vishal S. Arora and Sachin H. Jain (11/3/20)
The immediate benefits of capitation during the pandemic are obvious: Liquidity-constrained health systems receive cash inflow independent of procedures and office visits performed. There are also long-term benefits to capitation, such as rewarding judicious use of health care resources. However, often unstated are the key challenges and risks that health care organizations must navigate if they plan to execute capitation for their health systems in the long run. Read More
>>
DETERMINANTS OF HEALTH
Getting Our Knees Off Black People’s Necks: An Anti-Racist Approach to Medical Care
By Rupinder K. Legha, David R. Williams, Lonnie Snowden, and Jeanne Miranda (11/4/20)
Racism and anti-Blackness are inherent in
our country’s structures and medical systems. The authors propose an anti-racist approach to medical care that recognizes racism’s historical roots, identifies racism within health care providers and medical systems, and then dismantles it.
Read More >>
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About Health Affairs
Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.
Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.
Copyright © Project HOPE: The People-to-People Health Foundation, Inc.
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