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The Commonwealth Fund Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.




April 18, 2022

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Update: U.S. Vaccination Effort Prevented 2.2 Million Deaths
With the BA.2 Omicron subvariant now dominant in the United States, a study from Yale University and the Commonwealth Fund finds that the U.S. vaccination effort has profoundly curbed COVID-19’s toll. Updating estimates from December 2021, the researchers find that without vaccinations, there would have been 2.2 million additional U.S. deaths and 17 million additional hospitalizations related to COVID by the end of March 2022. Health care spending, meanwhile, would have been $900 billion higher.

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The U.S. Health System Is Failing Women of Reproductive Age
The U.S. health care system consistently fails to meet the needs of women of reproductive age, whether for maternal care, primary care, or mental health care, Commonwealth Fund experts say. Comparing health care access and outcomes for women ages 18 to 49 in 11 high-income countries, they found that U.S. women have the highest maternal death rate, are among the least likely to have a regular doctor, and are the most likely to report problems paying medical bills.

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Empowering Nurses to Improve Patient Care
Across the U.S., there’s a movement underway to empower nurses to design new approaches for solving the problems that plague health care. The new Transforming Care includes
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profiles of some of these initiatives , as well as an interview with Michelle Greanias, who’s leading
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an effort to reimagine nursing through new training approaches, innovative technology, and care delivery models that directly reimburse nurses for their work.

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How State Insurance Marketplaces Are Advancing Health Equity
The Affordable Care Act has helped reduce racial and ethnic disparities in health insurance coverage. But as Dania Palanker and Nia Denise Gooding write in their new report, better access to coverage is not enough to ensure “equitable access to the services needed to attain good health.” The researchers describe the strategies that four state-based health insurance marketplaces are pursuing to advance true health equity.

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Health Care Behind Bars, and Beyond
For some Americans who are incarcerated, jail or prison is the first time they’ve received health services as adults. Far too often, however, access to care vanishes once people move back into their communities. On The Dose podcast, Yale University’s Emily Wang, M.D., explains why it’s so important to ensure continuity of care for people cycling in and out of the criminal justice system.

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What U.S. Employers and Communities Are Doing About High Health Care Costs
In 2021, Peak Health Alliance, a Colorado health care purchasing coalition, used a price negotiation strategy to bring down premiums in the individual market by a whopping 35 percent. Local employers using the same fee schedule also realized savings. While coalitions like Peak have achieved mixed results over the years, their efforts show what’s possible when employers and communities take joint action, say Sarah Klein and Martha Hostetter in their new feature article.

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Costs and Benefits of Fixing the “Family Glitch”
The Biden administration has proposed a fix for the Affordable Care Act’s “family glitch” — a quirk in the law that prevents some 5 million Americans from qualifying for subsidies. Projections show that about a million families would save roughly $400 per person annually if the new rule is enacted; those with lower incomes would save even more. Health law expert Timothy Jost explains who benefits from the fix and how much it will it cost.

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“The Future of Medicare,” a Three-Part Virtual Series
For over 50 years, Medicare has provided health care coverage to people age 65 and older, as well as to millions of younger adults with certain disabilities or conditions. But as enrollment continues to climb, so does federal spending. What does this mean for Medicare, now and in the future? Beginning April 22, “The Future of Medicare,” a three-part virtual series, will consider the trade-offs of different policy options for ensuring the program’s long-term sustainability. The series is sponsored by the Commonwealth Fund in partnership with the Alliance for Health Policy and Arnold Ventures.

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Addressing the National Mental Health Crisis
On April 6, White House Domestic Policy Advisor Susan Rice delivered a major policy speech on mental health during the online event “Addressing the National Mental Health Crisis,” cohosted by the Brookings Institution and the Commonwealth Fund. Watch a video of the event, which also featured Fund President David Blumenthal, M.D., and leading experts discussing how we can address mental health needs both holistically and equitably.

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Does Easier Marketplace Enrollment Cause People to Postpone Signing Up for Coverage?
There’s been a longstanding debate around whether making it easier to enroll in a marketplace health plan would result in adverse selection. Some experts believe more people would wait until they become sick or injured before enrolling in coverage, while others think extending the ACA’s open enrollment period would actually bring in more healthy enrollees. As analysts Mark Hall and Michael McCue discovered, the pandemic provided a natural experiment for testing these competing theories. Learn what they found out.

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How to Strengthen Medicaid’s Health Care Safety Net
The health crisis brought on by the COVID-19 pandemic has heightened the critical importance of Medicaid and safety-net providers in delivering equitable care to historically underserved communities. In a new report, George Washington University’s Sara Rosenbaum and colleagues explain how policymakers can strengthen the health care safety net in ways that align with modern Medicaid practice and policy.

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End of Medicaid Enrollment Policy Enacted During COVID Could Hurt Many
An estimated 15 million Medicaid beneficiaries will lose their coverage in the first six months after the end of the federal government’s COVID-19 public health emergency declaration, when a temporary “continuous enrollment” policy begins to wind down. On To the Point, George Washington University’s Sara Rosenbaum and colleagues take a closer look at the stakes for people with low income — especially the sickest — when states resume determining eligibility for the program.

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Oregon Wants to Limit Medicaid Coverage of Accelerated-Approval Drugs
Many Oregon residents with low income could lose access to certain new high-priced medications if the federal government approves the state’s bid to deny Medicaid coverage of drugs that have been fast-tracked for approval by the Food and Drug Administration. But Medicaid financing expert Edwin Park argues that there are ways for federal policymakers to address problems in the accelerated-approval process without threatening access to needed medications.

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