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A Weekly Health Policy Round Up From Health Affairs            

**November 10, 2019**

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IN THE JOURNAL

NEW ISSUE:
HOUSEHOLD COSTS, FOOD & MORE

The November issue of

**Health Affairs** includes studies about the household burden of health
costs, the effects of the Supplemental Nutrition Assistance Program
(SNAP), different aspects of the Affordable Care Act (ACA), the quality
of care in hospitals, and global health policy.

The issue includes studies that are part of several ongoing series:
Aging & Health, supported by The John A. Hartford Foundation; The
Practice of Medicine, supported by The Physicians Foundation; and
Considering Health Spending, supported by the National Pharmaceutical
Council.

Read the November 2019 table of contents
.

Listen to a two-minute introduction of the issue from Editor-in-Chief
Alan Weil.

Read "From the Editor in Chief."

COSTS & SPENDING

Financial Hardships Of Medicare Beneficiaries With Serious Illness

By Michael Anne Kyle, Robert J. Blendon, John M. Benson, Melinda K.
Abrams, and Eric C. Schneider

Medicare's popularity stems from its universality and comprehensive
benefits, but Michael Anne Kyle and coauthors explore the program's
limitations when it comes to people with serious illness. They find that
53 percent of Medicare beneficiaries with illnesses requiring recent
hospitalizations or multiple physician visits report having a serious
problem paying a medical bill. Read More >>

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DETERMINANTS OF HEALTH

The Effect Of The Supplemental Nutrition Assistance Program On Mortality

By Colleen M. Heflin, Samuel J. Ingram, and James P. Ziliak

SNAP benefits are known to reduce food insecurity, but does that
translate into better health? Colleen Heflin and coauthors find that
SNAP participation reduces all-cause mortality by 1-2 percentage
points. It also reduces the likelihood of death from alcoholic liver
disease, poisoning, or suicide among people ages 40-64. Read More >>

Evaluating A USDA Program That Gives SNAP Participants Financial
Incentives To Buy Fresh Produce In Supermarkets

By Pasquale E. Rummo, Danton Noriega, Alex Parret, Matthew Harding, Oran
Hesterman, and Brian E. Elbel

Doubling the value of SNAP benefits when used at farmers markets
increases the purchase of fresh fruit and vegetables by low-income
people. Pasquale Rummo and coauthors examine the effects of a similar
program in grocery stores, where most food is purchased. Using data from
thirty-two supermarkets in Michigan, the authors find that SNAP
participants' spending on fruit and vegetables in participating
supermarkets was 7.4 percent and 2.2 percent higher than in control
supermarkets in 2015 and 2016, respectively. Read More >>

GLOBAL HEALTH POLICY

Cost-Effectiveness Of The Sugar-Sweetened Beverage Excise Tax In Mexico

By Ana Basto-Abreu, Tonatiuh Barrientos-Gutiérrez, Dèsirée
Vidaña-Pérez, M. Arantxa Colchero, Mauricio Hernández-F., Mauricio
Hernández-Ávila, Zachary J. Ward, Michael W. Long, and Steven L.
Gortmaker

Mexico imposed a sugar-sweetened beverage tax in 2014. Ana Basto-Abreu
and coauthors simulate the effects of the tax on obesity-related
diseases and health care spending over ten years. They find that the
current tax of one peso per liter will prevent 239,900 cases of obesity
and 61,340 cases of diabetes, while saving $3.98 of health care costs
(adjusted) for every dollar spent. These health benefits and savings
lead the authors to recommend similar taxes in countries with comparable
conditions. Read More >>

Noncommunicable Diseases Attributable To Tobacco Use In China:
Macroeconomic Burden And Tobacco Control Policies

By Simiao Chen, Michael Kuhn, Klaus Prettner, and David E. Bloom

China is the world's leading tobacco producer and consumer. Simiao
Chen and coauthors estimate the economic burden of tobacco consumption
arising from eight tobacco-attributable diseases at US$2.3 trillion in
the period 2015-30 and suggest that "if China raised the tobacco tax
to 75 percent of the current retail price and implemented complementary
policies..., the country's economy could save 7.1 trillion yuan
(US$1.0 trillion) from 2015 to 2030." Read More >>

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NARRATIVE MATTERS: ETHICS

Measles, Mumps, And Communion: A Vision For Vaccine Policy

By Joshua T. B. Williams

A pediatrician offers a vision for vaccine policy that promotes public
health while respecting religious beliefs. Read More >>

Listen to the podcast.

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THIS WEEK ON THE BLOG

FOLLOWING THE ACA

****

New York Court Vacates Conscience Rule

By Katie Keith  (11/7/19)

Judge Paul A. Engelmayer, a federal district court judge in the Southern
District of New York, vacated a provider conscience regulation that
would have expanded and consolidated enforcement authority over a
variety of federal health care conscience laws, including three parts of
the Affordable Care Act. Read More >>

Georgia Releases Broad 1332 Waiver Application

By Katie Keith   (11/5/19)

The application reflects a two-phase approach: a state-based reinsurance
program to begin in plan year 2021, followed by a transition to the
"Georgia Access" model beginning in plan year 2022. Read More >>

CMS Issues Final Rule On BHP Methodology

By Katie Keith (11/4/19)

This change is expected to decrease federal funding for the Basic Health
Program by about $151 million for 2020. States are expected to make up
this shortfall through additional state funding, higher premiums and
costs for beneficiaries (within limits), and lower provider and plan
payment rates. Read More >>

MEDICARE

Assessing The Redesigned Medicare Plan Finder Tool: Room For Improvement

By Brian E. McGarry, Nicole Maestas, and David C. Grabowski (11/8/19)

Many of the changes made to the plan finder this year are clear
improvements. But other changes are not clearly beneficial and may, in
fact, steer users away from low-cost options. Read More >>

HIV/AIDS

Correcting The Contradictions: Immigration Policy And HIV

By Amir M. Mohareb, Rochelle P. Walensky, and Emily P. Hyle (11/8/19)

The Departments of Homeland Security and Health and Human Services
should immediately end this inaccurate interpretation of HIV as a
"communicable disease" meriting family separation and double efforts to
stop family separation, prolonged detention, and discriminatory
immigration practices for migrants and asylum seekers with HIV.
Read More >>

CONSIDERING HEALTH SPENDING

Hot-Spotting North Carolina's Medicaid Transformation

By Kushal T. Kadakia, Shivani A. Shah, and Barak D. Richman (11/5/19)

Meaningful health policies for rural America must focus on the needs of
those Americans and the resource gaps that surround them. Read More >>

ACCESS TO CARE

Bridging The Gap In Rural Health Access

By Robert Brodell (11/7/19)

By applying innovative approaches such as rural residencies, community
clinics, and teledermatology, the field of dermatology is striving to
bridge the gap in rural health access. Read More >>

PHARMACEUTICALS AND MEDICAL TECHNOLOGY

Self-Managed Abortion May Be On The Rise, But Probably Not A Significant
Driver Of The Overall Decline In Abortion

By Rachel K. Jones and Megan K. Donovan (11/7/19)

As we look ahead at what the future holds for abortion access in the
United States, it will be critical to put in place policies and
practices that ensure that people self-managing their care have the
information and support they need. Read More >>

SMOKING PREVENTION

Tobacco Use Reduction: Policy Wins In Kentucky

By Ben Chandler (11/7/19)

A foundation has started doing most of its own advocacy work and,
working with a broad coalition, has racked up two significant policy
wins: an increased state cigarette excise tax and a model tobacco-free
schools policy. By July 1, 2020, each school district must pass the
tobacco-free campus policy or opt out (so far, only one has opted out).
The author, the foundation's president and CEO and a former member of
Congress, describes how these wins were achieved. Read More >>

MEDICAID

The Effects Of The Comprehensive Addiction And Recovery Act Of 2016 On
Nurse Practitioner And Physician Assistant Buprenorphine Prescribing in
Medicaid

By Karin E. Johnson, Rekha Varghese, Bo Feng, Mike Liu, Ali Sanford,
Paul Dowell, and John Wedeles (11/6/19)

Granting authority to prescribe buprenorphine, regardless of clinician
specialty, is only one of many efforts to ensure access to treatment.
Read More >>

PHARMACEUTICALS AND MEDICAL TECHNOLOGY
Assessing Drug Pricing Reform Proposals: The Real Leverage And Benefits
Of Competitive Licensing

By Christopher J. Morten and Amy Kapczynski (11/4/19)

Competitive licensing proposals have significant advantages, and
competitive licensing can also be combined with other solutions,
including taxes, to achieve effective reform of prescription drug
pricing. Read More >>

HEALTH AFFAIRS EVENTS-SAVE THE DATE

Rural Health Briefing - December 4 (registration opening soon)

Get notified when
there's more information available on this event.

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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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