Affordable Care Act
lborkowski | December 7, 2016Recent news has highlighted just how important and popular the Affordable Care Act has been, but its fate under a Trump administration and Republican Congress is uncertain. Congressional Republicans have voted repeatedly to repeal the ACA, but now that they actually have a shot at doing that, journalists and commentators are focusing on how hard it will be to preserve the provisions voters like and politicians vow to keep – let alone the gains in insurance coverage and financial stability.
Between the law’s passage in 2010 and early 2016, an estimated 20 million people gained health insurance…
kkrisberg | December 6, 2016At Stat, Eric Boodman reports on whether a Trump administration might deprive miners of compensation for disabilities related to black lung disease.
In particular, Boodman examines a little-known provision in the Affordable Care Act (ACA) that shifted the burden of proof from miners and onto mining companies. In other words, if miners had spent at least 15 years underground and can prove a respiratory disability, it’s assumed to be an occupational illness. However, if the ACA is repealed in full — as candidate Trump promised on the campaign trail — that provision would go away as well, making…
oracknows | November 29, 2016I’m always hesitant to write about matters that are more political than scientific or medical, although sometimes the sorts of topics that I blog about inevitably require it (e.g., the 21st Century Cures Act, an act that buys into the myth that to bring "cures" to patients faster we have to neuter the FDA and a retooled version of which is still being considered). This is one of those times. Yesterday, I woke up to the news that President-Elect Donald Trump had chosen Rep. Tom Price (R-GA) as his new Secretary of Health and Human Services. The Department of Health and Human Services (DHHS),…
kkrisberg | November 29, 2016The percentage of Americans who reported cost-related barriers to health care dropped from 37 percent in 2013 to 33 percent in 2016 — a change that directly corresponds to insurance expansions under the Affordable Care Act, a new study reports. On the flip side, Americans are still more likely than peers in other high-income nations to face financial obstacles to health care.
The study is based on findings from a survey of patients and providers in 11 countries and one that the Commonwealth Fund has been conducting annually since 1998. Those 11 countries are: Australia, Canada, France,…
kkrisberg | November 11, 2016Three days out from the election and many of us are still trying to adjust to this new reality. It’s been a very rough week.
And assuming that we take the new president-elect at his word — that we believe the promises he made on the campaign trail — public health workers and advocates, as well as the often-vulnerable people and communities they serve, now face a very difficult four years. Fortunately, public health has plenty of practice confronting and overcoming powerfully entrenched interests for the greater good. Just ask Big Tobacco.
In that vein, below are excerpts from post-election…
kkrisberg | November 1, 2016Celeste Monforton and I are currently in Denver at the American Public Health Association's (APHA) 2016 Annual Meeting and Exposition — the year’s largest gathering of public health professionals. The meeting is packed with hundreds of scientific sessions, leading public health researchers and new findings on just about any public health topic you can imagine. Below are some highlights of the past few days, courtesy the APHA Annual Meeting Blog.
Trees don’t just make neighborhoods pretty. They can also save lives: With flowers in the spring, lush green leaves in the summer and changing colors…
kkrisberg | October 28, 2016While health policy hasn’t been at the forefront of this year’s presidential election, the next person to sit in the White House could have a transformative effect on health care access, affordability and inequity. Of course, with so many variables in play, it’s hard to predict what either candidate could realistically accomplish on the health care front. However, a new report might provide some insightful clues.
Published this week in the New England Journal of Medicine, the report complied results from 14 national public opinion polls from various sources and conducted as recently as…
kkrisberg | October 13, 2016If you look at the numbers, there’s no doubt that the Affordable Care Act is making a positive difference. In fact, just last month, the U.S. Census Bureau reported that the nation’s uninsured rate had hit a record low. At the same time, the health reform law wasn’t intended as a silver bullet and a number of problems remain. One of those problems is known as “churning.”
“Churning” describes changes in a person’s insurance coverage over time and it’s an issue that can have a significant impact on a patient’s continuity of care and health status. Of course, changes in insurance coverage are…
lborkowski | September 12, 2016The latest findings on US health insurance coverage from the first quarter of the current year continue what is becoming a familiar story: The portion of the US population without health insurance continues to decline. This year, the estimate from CDC's National Center for Health Statistics is that 8.6% of US people of any age were without health insurance at the time of interview from January - March 2016.
As it did last year, the report highlights the difference between states that have accepted the Affordable Care Act's Medicaid expansion and those that have not:
In Medicaid expansion…
lborkowski | August 8, 2016In MMWR, Brian Ward and Lindsey Black of the National Center for Health Statistics report that 25.7% of US adults have been diagnosed with multiple chronic conditions (MCC). In their analysis of data from the 2014 National Health Interview Survey, they examined rates of diagnoses of arthritis, asthma, cancer, COPD, coronary heart disease, diabetes, hepatitis, hypertension, stroke, or weak/failing kidneys.
It's not surprising that MCC prevalence varied by age; just 7.3% of those aged 18-44 had multiple chronic conditions, compared to 32.1% of those aged 45-64 and 61.6% of those aged 65 and up…
lborkowski | July 18, 2016In a Special Communication published in JAMA, President Obama assesses the Affordable Care Act's progress and recommends additional steps for elected officials to take to improve US healthcare. He notes that when he took office, more than 1 in 7 Americans lacked insurance coverage. Since the ACA's adoption, the uninsured rate has declined by 43%. Having 29 million people uninsured in this country is still shameful, but it's a big improvement over the 49 million uninsured in 2010.
In addition to reducing uninsurance, Obama notes, "The law has also greatly improved health insurance coverage for…
kkrisberg | May 31, 2016Everything’s bigger in Texas — including the number of Texans without health insurance. But thanks to the Affordable Care Act, the percentage of uninsured Texas residents has dropped by 30 percent. That means the Texas uninsured rate has hit its lowest point in nearly two decades.
In a new issue brief from Rice University’s Baker Institute for Public Policy, researchers report that the Texas uninsured rate dropped from 26 percent in September 2013 — before the ACA’s first open enrollment period — to 18 percent as of March 2016. The decline was observed among every age, income and ethnic group…
kkrisberg | May 5, 2016Just in time for Mother’s Day comes more good news from the Affordable Care Act: the rate of uninsured moms caring for kids younger than 19 has dropped to its lowest rate in nearly 20 years.
According to a new analysis from the Urban Institute released this month, the rate of uninsured moms fell 3.8 percentage points between 2013 and 2014 — that’s a decline about three times as large as any of the previous year-to-year changes observed since 1997. In sheer numbers, that means about 1.6 million moms gained health insurance. To give you even more perspective, consider that uninsurance rates…
kkrisberg | March 25, 2016Here’s what states get when they expand Medicaid: more savings, more revenue, more jobs, more access to care for their communities.
That’s the conclusion from a Robert Wood Johnson Foundation issue brief released this month that compared the differences between states that chose to expand Medicaid eligibility under the Affordable Care Act and those that opted out. Under the health reform law, the federal government will pay the entire cost of expanding state Medicaid programs up to 138 percent of the federal poverty level through 2016, phasing down to 90 percent by 2020. It’s a pretty good…
kkrisberg | February 10, 2016President Obama released his 2017 federal budget proposal yesterday, recommending funding boosts for a number of public health priorities. And even though his presidency is coming to an end and so this budget is probably dead on arrival in the Republican-controlled Congress, it’s worth a peek inside.
Here are some of the highlights that seem particularly relevant to public health, health care and working families:
Health care access: The Obama budget would expand federal financing to cover the costs of state Medicaid eligibility expansions. That means the federal government would fully cover…
kkrisberg | November 25, 2015Public health insurance programs often get a bad rap, despite a growing positive evidence base on their patient care, quality and outcomes. Earlier this month, another study emerged that found Medicaid and the Children’s Health Insurance Program not only outperform private insurance when it comes to children’s preventive care, they can serve as a model of comprehensive children’s coverage.
Published in JAMA Pediatrics, the study is based on data from the U.S. National Surveys of Children’s Health between 2003 and 2012 — a sample of more than 80,000 children up to age 17 living in households…
cmonforton | November 4, 2015Kim Krisberg and I are with our public health colleagues this week at the 143rd annual meeting of the American Public Health Association (APHA). More than 12,000 researchers, practitioners, and advocates from across the US and the globe have gathered in Chicago to swap best practices, share new science and organize for healthier communities. Here are some highlights from yesterday’s events courtesy of the APHA Annual Meeting Blog.
“Stop asking for a seat at the table…we belong at the head of the table": In April in Baltimore, after the civil unrest that followed the death of Freddie Gray…
kkrisberg | October 30, 2015When it comes to immunization rates in the United States, the story is a mixed one. Among children, we’ve absolutely excelled. In fact, the Centers for Disease Control and Prevention considers the nation’s childhood vaccination rate as one of the greatest public health achievements of the 20th century. But when it comes to American adults — 50,000 of whom die every year from vaccine-preventable diseases — it’s a very different story.
Earlier this year, CDC’s Morbidity and Mortality Weekly Report reported that uptake of recommended adult immunizations remains low and is far below Healthy…
kkrisberg | October 22, 2015More good news from the Affordable Care Act: Since it became the law of the land, uninsurance disparities between white, black and Hispanic residents have narrowed significantly.
In a study published this month in the journal Health Affairs, researchers found that by the fourth quarter of 2014, the uninsurance rate for Hispanic adults had fallen to 31.8 percent from about 40 percent in the third quarter of 2013. During the same time period, uninsurance among black adults declined from 25.5 percent to 17.2 percent, while uninsurance among white adults fell from 14.8 percent to 10.5 percent.…
lborkowski | August 17, 2015The CDC's National Center for Health Statistics has published an early release of findings on US health insurance coverage from January - March 2015, and the numbers show a continued decline in the number of US residents without health insurance. The report presents findings from the National Health Insurance Survey, and the headline estimate is that just 9.2% of people (29 million) were uninsured at the time of the interview. That's down from the same time period last year, when 13.4% lacked insurance coverage.
The report notes that since 2010, the decline in uninsurance among adults ages 18…