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.

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.

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