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.

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 >>

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 >>

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 >>

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 >>

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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