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The Latest Research, Commentary, And News From Health Affairs

April 11, 2021

Dear John,

The April 2021 edition of Health Affairs covers a variety of topics
about access to and quality of care, the Affordable Care Act, health
spending, and more. Read on for more highlights from Health Affairs this
week.

Access, ACA, Spending & More

Our latest journal issue
includes research on
some of Health Affairs' most popular topics: access to Medicare and
Medicaid, the Affordable Care Act's impact on coverage and outcomes,
the effects of various policies on health spending, and much more.
Editor-in-Chief Alan Weil has a preview of the issue
.

In one study
,
Eric Roberts and coauthors found that Medicare isn't benefiting all
enrollees equally. Beneficiaries with incomes exceeding the eligibility
thresholds for Medicaid and Medicare Part D subsidies are estimated to
face more than $2,200 in additional out-of-pocket costs over two years
and are more likely to incur catastrophic medical bills.

In another study
,
Adam Biener and colleagues reveal the cost of out-of-network emergency
department visits: Patients who likely received a surprise
out-of-network bill for emergency care paid physicians ten times more
out of pocket than patients receiving in-network emergency care.

Emily Johnston and coauthors examined the effect of Medicaid expansion
on low-income pregnant women. Their findings show that, in states that
didn't expand coverage, half of women with prenatal Medicaid coverage

experienced a period without insurance in the weeks before or after
birth. In states that did expand Medicaid, only one in five lost
insurance during the perinatal period.

Makayla Palmer and coauthors studied the evolution of advance care
planning, the setting of these discussions, and the demographics of
participating patients. The authors found steady growth in the number of
fee-for-service Medicare beneficiaries doing outpatient advance care
planning

between 2016 and 2019, but prevalence remained below 7.5 percent for all
demographics. Their results also suggest that advance care planning
conversations at and apart from annual wellness visits may play
different roles.

Health Affairs Blog featured two new posts by Katie Keith this week. In
the first, she discusses how, while the country waits for the Supreme
Court's decision in California v. Texas, insurers have asked the court
to review an appellate decision

reducing their potential recovery for unreimbursed cost-sharing
reductions. In the second, Keith covers the recent news that more than
528,000 people have enrolled in Marketplace coverage during the broad
special enrollment period
.
This includes more than 206,000 consumers who selected a plan in
February and 322,000 consumers who did so in March.

Also on the blog this week, Rep. Richard Neal (D-MA), chairman of the
House Committee on Ways and Means, discusses how the newly launched
Racial Equity Initiative

will help his committee address racial inequities as a root cause of
health and economic disparities.

Featured Journal Articles

Access, ACA, Spending, And More

Alan R. Weil

Medicaid Coverage 'Cliff' Increases Expenses And Decreases Care For
Near-Poor Medicare Beneficiaries

Eric T. Roberts, Alexandra Glynn, Noelle Cornelio, Julie M. Donohue,
Walid F. Gellad, J. Michael McWilliams, and Lindsay M. Sabik

Emergency Physicians Recover A Higher Share Of Charges From
Out-Of-Network Care Than From In-Network Care

Adam I. Biener, Benjamin L. Chartock, Christopher Garmon, and Erin Trish

Post-ACA, More Than One-Third Of Women With Prenatal Medicaid Remained
Uninsured Before Or After Pregnancy

Emily M. Johnston, Stacey McMorrow, Clara Alvarez Caraveo, and Lisa
Dubay

Advance Care Planning For Medicare Beneficiaries Increased
Substantially, But Prevalence Remained Low

Makayla K. Palmer, Mireille Jacobson, and Susan Enguidanos

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The ACA Led To An Increase In The Contraceptive-Curious

Listen to Alan Weil interview Nora Becker from the University of
Michigan on the affordability of long-acting reversible contraceptives,
how the Affordable Care Act impacted the costs associated with such
devices, and the role of behavioral economics in choosing a health plan.

****

Listen Here

On The Blog This Week

The Importance Of Including Diverse Voices In Maternal Mortality Review
Committees

Jane E. Ellis, Catherine Morris, David Goodman, and Julie Zaharatos

Investing In Evidence To Inform Practice: Reimagining The US Public
Health System

Erika G. Martin and Betty Bekemeier

Multisector Partnerships Such As ACHs: How Can They Improve Population
Health And Reduce Health Inequities?

Caroline Brunton, TC Duong, Feygele Jacobs, Jeffrey Levi, Phyllis
Meadows, Bonnie Midura, Shao-Chee Sim, Richard Thomason, and Anne F.
Weiss

ACA Litigation Round-Up, Part 1: Fight Over Reimbursements For
Cost-Sharing Reductions Continues

Katie Keith

HealthCare.gov Enrollment Continues To Rise During Special Enrollment
Period

Katie Keith

A Next Frontier In Health Care Transparency: Health Plan Drug Coverage
Policy

James D. Chambers and Peter J. Neumann

Insurer Formularies Complicate The Adoption Of Biosimilar Cancer
Therapies

Alice J. Chen, Priya Bhanot, Laura Gascue, Rocio Ribero, Rita Shane, and
Karen Van Nuys

The Time For Change: Prioritizing Health And Economic Equity In The
117th Congress And Beyond

Richard E. Neal

To Sustain The Value Movement, Make Next Generation ACOs A Permanent
Option

Jeff Micklos, Joshua Traylor, Mara McDermott, Kelsey Haag

What Are Foundations Doing To Help Understand And Diminish The Barriers
To People Getting Available COVID-19 Vaccines?

Allen Smart

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Podcast: A Renewed Effort To Address The Opioid Epidemic

It's National Public Health Week, and Secretary of Health and Human
Services Xavier Becerra just renewed the agency's emergency
declaration for the opioid crisis. Listen to Senior Editor Leslie
Erdelack and Health Equity Director Vabren Watts discuss why.

Listen Here

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mailto:[email protected]

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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