Health Affairs

JUST RELEASED The September 2024 issue is now available! Read Editor in Chief Alan Weil's introduction to the new issue on Access To Care, Coverage & More. Explore the issue: https://bit.ly/3Xs9OGT

In their new Forefront article, Bruce Lesley and Glenn Flores of First Focus on Children and the University of Miami Miller School of Medicine argue that, as the 2024 presidential and congressional elections draw near, it is crucial to highlight key policy needs and concerns in children’s health so that they are prioritized in candidates’ platforms. "We know what policies work to combat child poverty. Cash assistance to families not only reduces child poverty, but also improves children’s health, educational, and economic outcomes. The 2021 Child Tax Credit expansion prevented nearly three million children from experiencing poverty and reduced food insufficiency by over 25 percent. A key policy priority should therefore be a Child Tax Credit expansion at or above the 2021 expansion, and that includes Puerto Rico, which has an alarming 54.3 percent child poverty rate. Setting a national child poverty-reduction target would provide a tool to hold lawmakers accountable; other countries - including the United Kingdom and Canada - cut child poverty rates by half and more than one-third, respectively, after setting targets." Read the full article here: https://bit.ly/48plRJa

In response to diversifying needs of Medicaid long-term care services (LTSS), Katherine Rohde, then of University of Pennsylvania Carey Law School now of Arnold & Porter, and coauthors highlight the need to streamline the current process to enhance accessibility for all beneficiaries. Read the full article here: https://bit.ly/4eTaX0J

In their new Forefront article, Paul Hughes-Cromwick, Elliott Fisher, and Len Nichols from Trinity Health, The Dartmouth Institute for Health Policy & Clinical Practice, and the Urban Institute argue that, contrary to ACA opponents’ overhyped worries, health care cost growth has fallen through coverage expansions since the late 1980s. "A barrier to addressing this problem is the assumption that filling current gaps in access and generosity will lead to an acceleration in health care cost growth. We investigate three streams of evidence that call this assumption into question. First, we show that large insurance expansions under the ACA did not lead to accelerated cost growth (and thus further expansions need not do so, either). Second, we review the evidence on high-deductible health plans, showing their harmful repercussions. Third, we describe the policy levers that contributed to the slowing of spending growth to argue that we can have our cake and eat it too; we can have universal coverage, affordable cost sharing, and continued cost growth deceleration." Read the full article here: https://bit.ly/4dVLkuM

In their new Forefront article, Caroline Marra, Amy P. Abernethy, and Sean R. Tunis of Verily, Highlander Health, and the Center for the Evaluation of Value and Risk in Health (CEVR) illustrate the potential impact of their framework for fit-for-purpose (FFP) study design and data source selection in the context of Medicare “coverage with evidence development“ (CED) by examining how it might have affected two instances where CED was employed. "Medicare’s endorsement of FFP studies is a step forward in advancing the feasibility of ongoing evidence generation for emerging medical products, but details around the process that CMS will use to determine what constitutes a FFP study in the context of conditional coverage are needed. In light of Medicare’s plans to issue FFP study guidance, our FFP framework is intended to inform its development by offering an approach to FFP study design and data-source selection along with suggestions for how CMS can support adoption of FFP studies in the context of ongoing evidence generation requirements." Read the full article here: https://bit.ly/3A6zVdO

Naomi Zewde of UCLA Fielding School of Public Health and coauthors take a close look at the impact of high-deductible plans on racial and ethnic wealth disparities. Read the full article here: https://bit.ly/48dhnoO

In their new Forefront article, Jeffrey Willet and Maher Karam-Hage suggest tobacco control in the US has reached an endgame phase, during which public health must embrace a stronger agenda to reduce and ultimately eliminate combustible tobacco use—or else risk making a blunder that could unnecessarily prolong the epidemic of smoking-related disease and deaths. "After 60 years of moves and countermoves with industry, public health is theoretically “winning,” with historically low rates of adult smoking and significant recent reductions in youth e-cigarette use. However, despite overall reductions in smoking, inequities remain for people with lower socioeconomic backgrounds, the LGBTQIA+ community, and people with mental health conditions. Without adjustments to public health strategy, we will continue seeing a slow and inequitable reduction in tobacco-related deaths." Read the full article here: https://bit.ly/4fdqMyX

In their new Forefront article, Caroline Marra, Amy P. Abernethy, and Sean R. Tunis of Verily, Highlander Health, and the Center for the Evaluation of Value and Risk in Health (CEVR) offer a framework for fit-for-purpose study design and data source selection in the context of Medicare “coverage with evidence development“ (CED). "...[CED] provides for Medicare coverage of selected emerging medical products on the condition that they are furnished in the context of Medicare-approved clinical studies. An explicit, structured approach to designing these studies is essential to achieving the policy goals of CED, as they involve an inherent and complex balancing act: how to resolve uncertainties about the performance of a novel product in the Medicare population without imposing unnecessary data collection burden or unduly restricting access to the product by Medicare beneficiaries." Read the full article here: https://bit.ly/4dW5W64

Whitney Wells of Harvard T.H. Chan School of Public Health et al examine the rise in food insufficiency among SNAP participants following the expiration of COVID-19 emergency allotments in March 2023. Read the full article here: https://bit.ly/4eM1b0h

Call for Papers | Health Affairs Scholar is seeking research studies and commentaries on global aging, intersections of social policies and health, and policy options for the 340B Drug Discount Program. Manuscripts submitted by Dec 2024 have the best chance of acceptance. Learn more: https://bit.ly/3YxwoP5