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The Latest Research, Commentary, And News From Health Affairs

Tuesday, March 23, 2021

Dear John,

On the anniversary of the passage of the Affordable Care Act, we examine
the financial impact of the ACA's insurance subsidies and reflect on
the past eleven years under the law.

Marketplace Subsidies Associated With Reduced Financial Burden

Today is the eleven-year anniversary of the passage of the Affordable
Care Act (ACA). In addition to the largest expansion of insurance
coverage since the creation of Medicare and Medicaid, the law ushered in
health care payment and service delivery changes.

One criticism the law has received is that the health coverage offered
through the ACA Marketplaces has high levels of deductibles and
copayments, leaving care unaffordable to many. In their recent Health
Affairs paper, Charles Liu and coauthors analyzed expenditure survey
data and found sizable reductions in the cost burden of health care

for low-income Marketplace enrollees. Low-income adult enrollees
experienced a 17.2 percent decline in out-of-pocket spending and an
almost one-third drop in the likelihood of having catastrophic health
expenditures across the study period of 2008 to 2017.

For a look back at the first decade of the ACA, revisit our March 2020
issue, The Affordable Care Act Turns 10
.
It offers a comprehensive review of what the law accomplished and what
remains to be done.

In their new Health Affairs Blog post, Soleil Shah and coauthors argue
that, in health care, public benefit corporations

could simultaneously improve individual patient outcomes and collective
benefit without sacrificing institutions' financial stability. Also,
Sara Rosenbaum and coauthors look at the structure of and interactions
between several key provisions of the American Rescue Plan Act
,
including the COVID-19 coverage and treatment mandate, the postpartum
Medicaid coverage option, and the Medicaid expansion incentive and its
relationship to section 1115 of the Social Security Act.

A new episode of A Health Podyssey was released today. Listen as Alan
Weil interviews March authors Maximilian J. Pany and Lucy Chen about
their research comparing team-based and solo care
.
They found that patients who have their care managed by teams were more
likely to have their chronic disease brought under control, regardless
of the composition of the team members. Among solo providers, physicians
and nonphysicians exhibited little meaningful difference in performance.

Elevating Voices In Women's History Month: Geriatrician Diane E. Meier
won a MacArthur "genius award" for her work in palliative care at
Mount Sinai. She shared a powerful story regarding overtreatment and
end-of-life care in her Narrative Matters essay, "I Don't Want Jenny
To Think I'm Abandoning Her
."

If you are learning from and enjoying the free content on our blog and
in our podcasts, please consider supporting our work
.

****

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Do Teams Work Better Than Solo Providers? Spoiler Alert: Yes

Listen to Alan Weil interview Maximilian Pany and Lucy Chen, both MD-PhD
candidates in health policy at Harvard Medical School, on their
research, which found that provider teams outperformed solo providers in
managing chronic diseases.

Listen Here

Your Daily Digest

The Affordable Care Act's Insurance Marketplace Subsidies Were
Associated With Reduced Financial Burden For US Adults

Charles Liu, Hiroshi Gotanda, Dhruv Khullar, Thomas Rice, and Yusuke
Tsugawa

Public Benefit Corporations: A Third Option For Health Care Delivery?

Soleil Shah, Jimmy J. Qian, Amol S. Navathe, and Nirav R. Shah

Medicaid And The American Rescue Plan: How It All Fits Together

Sara Rosenbaum, Morgan Handley, Maria Casoni, Rebecca Morris, and Erin
Handley

'I Don't Want Jenny To Think I'm Abandoning Her': Views On
Overtreatment

Diane E. Meier

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About Health Affairs

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, and Health Affairs Sunday
Update .  

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