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        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - October 16, 2019 Category: International Medicine & Public Health Authors: David Blumenthal, M.D. Source Type: blogs

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In a new To the Point post, the Commonwealth Fund’s Shanoor Seervai and Roosa Tikkanen explain that American women already struggle to afford the care they need, especially compared to women in other high-income countries, and have worse health outcomes as well. A key difference in these other countries is universal access to free or affordable contraceptives.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - October 10, 2019 Category: International Medicine & Public Health Authors: Shanoor Seervai, Roosa Tikkanen, Sara R. Collins Source Type: blogs

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Prescription drug importation could be particularly important for public health agencies by allowing them to stretch their resources further.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - October 4, 2019 Category: International Medicine & Public Health Authors: Jane Horvath, So Yeon Kang Source Type: blogs

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        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - October 1, 2019 Category: International Medicine & Public Health Authors: Rachel Nuzum, Akeiisa Coleman, Audrey McIntosh Source Type: blogs

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The Tennessee legislature recently enacted a law to seek federal approval to fund Medicaid through block grants. The plan would likely have indeterminate consequences for Medicaid beneficiaries. George Washington University’s Sara Rosenbaum delves into the potential impact of Tennessee’s new law.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - September 25, 2019 Category: International Medicine & Public Health Authors: Sara Rosenbaum Source Type: blogs

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        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - September 20, 2019 Category: International Medicine & Public Health Authors: Jack Hoadley, Beth Fuchs, Kevin Lucia Source Type: blogs

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High and variable health care prices are the major drivers of health care spending in the private insurance sector in the United States. Most discussions about this problem focus on federal policy solutions or private negotiations between insurers, providers, and manufacturers. However, states can also be key players in addressing these issues.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - September 13, 2019 Category: International Medicine & Public Health Authors: Lovisa Gustafsson, Audrey McIntosh Source Type: blogs

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Rhode Island has one of the best-performing health systems in the country, ranking seventh overall in the Commonwealth Fund’s 2019 Scorecard on State Health System Performance. It also has the most improved health system of any state.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - September 11, 2019 Category: International Medicine & Public Health Authors: Michelle Alletto, Marie Ganim Source Type: blogs

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        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - September 5, 2019 Category: International Medicine & Public Health Authors: Lauren Vela Source Type: blogs

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The Affordable Care Act’s insurance reforms aimed to create a set of favorable market conditions to help the small-group and individual markets perform more like the well-functioning large-group market. Thus one way to measure the effectiveness of the ACA’s reforms is to observe the extent to which these market segments have converged in terms of profitability and premiums or have continued to differ on such measures. In this post, we consider whether the three market segments report similar — or substantially different — financial performance during the first four years of the ACA.   &nb...
Source: The Commonwealth Fund: Blog - August 27, 2019 Category: International Medicine & Public Health Authors: Mark A. Hall, Michael J. McCue Source Type: blogs

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While Congress and many Americans are taking an August break, lawsuits about the Affordable Care Act (ACA) grind on in the federal courts. In this post, we review the current status of the major cases, including those challenging the validity of the ACA and related regulations and those challenging Trump administration initiatives that undermine the ACA.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - August 21, 2019 Category: International Medicine & Public Health Authors: Timothy S. Jost Source Type: blogs

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Last week the Trump administration published its long-anticipated proposed “public charge” rule, which carries enormous implications for Medicaid and immigrants enrolled in the program. A public charge is an individual considered dependent on the government for subsistence. The proposal would radically expand the extent to which public benefits received by legal immigrants who are not yet citizens are used as evidence of public charge status.          (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - August 15, 2019 Category: International Medicine & Public Health Authors: Sara Rosenbaum Source Type: blogs

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Whether it’s hospital closures or shortages of health professionals, many people in rural America face barriers getting the health care they need. The problem is particularly acute for an often-overlooked group: pregnant women.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - August 15, 2019 Category: International Medicine & Public Health Authors: Corinne Lewis, Isabel Paxton, Laurie Zephyrin, M.D. Source Type: blogs

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Timely access to family planning can reduce the occurrence of pregnancy-related deaths, which are increasing significantly in the U.S. in contrast to most other developed nations. But federal and state policies — driven partly by a political opposition to abortion rights — are putting women’s access to comprehensive health care at risk.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - August 14, 2019 Category: International Medicine & Public Health Authors: Cindy Mann, Nina V. Punukollu Source Type: blogs

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Health care took center stage on both nights of the most recent Democratic debates, a reminder of how worried Americans are about getting and affording health care. Their concerns are not unfounded. More than 30 million do not have health insurance, which puts them at greater risk of illness, and possibly death. A new study from the National Bureau of Economic Research shows that 15,600 deaths between 2014 and 2017 could have been avoided if all states expanded Medicaid.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - August 10, 2019 Category: International Medicine & Public Health Authors: Shanoor Seervai, David Blumenthal, M.D. Source Type: blogs

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The Commonwealth Fund has long tracked premature death as a way to measure the effectiveness of care delivery. The measure includes deaths before age 75 from illnesses that are generally considered treatable, as long as they are detected early and effectively managed. Examples include deaths from diabetes before age 50, measles before age 14, or thyroid disease or appendicitis before age 75.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - August 7, 2019 Category: International Medicine & Public Health Authors: David C. Radley Source Type: blogs

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While bipartisan and bicameral efforts to address prescription drug prices and affordability is encouraging, the current proposals only address some of the problems our health system is facing. As policymakers and presidential candidates consider how to tackle prescription drug pricing, what issues still need to be addressed to bring down prices?         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 31, 2019 Category: International Medicine & Public Health Authors: Lovisa Gustafsson Source Type: blogs

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As we outlined earlier this spring, congressional action on drug pricing continues to intensify. Key committees have advanced an array of reforms, demonstrating Congress’ intent to finalize legislation this year. We aim to clarify what that might include.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 31, 2019 Category: International Medicine & Public Health Authors: Billy Wynne, Josh LaRosa, Alyssa Llamas Source Type: blogs

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While the administration argues that the change will strengthen the marketplaces, it could instead destabilize individual markets if they get an influx of high-cost enrollees. Ultimately, the impact will depend on how well the final rule guards against employers using Health Reimbursement Arrangements (HRAs) to cover high-cost employees.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 25, 2019 Category: International Medicine & Public Health Authors: JoAnn Volk, Kevin Lucia Source Type: blogs

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        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 22, 2019 Category: International Medicine & Public Health Authors: Mekdes Tsega, Tanya Shah, Corinne Lewis Source Type: blogs

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In a new To the Point post, the Commonwealth Fund’s Shanoor Seervai and Roosa Tikkanen explain that American women already struggle to afford the care they need, especially compared to women in other high-income countries, and have worse health outcomes as well. A key difference in these other countries is universal access to free or affordable contraceptives.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 17, 2019 Category: International Medicine & Public Health Authors: Shanoor Seervai, Roosa Tikkanen, Sara R. Collins Source Type: blogs

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A total of 27 states have enacted at least some consumer protections against surprise medical bills, a problem that's been gaining increasing attention. Some states go much further than others in protecting patients from surprise medical bills, such as banning balance billing, extending protections to in-network hospitals settings, and adopting dispute resolution         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 16, 2019 Category: International Medicine & Public Health Authors: Jack Hoadley, Kevin Lucia, Maanasa Kona Source Type: blogs

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The future of the Affordable Care Act (ACA), the millions of Americans who depend on it, and, frankly, the American health care system, every part of which is touched by the ACA, were on the line in a federal courthouse in New Orleans on Wednesday.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 12, 2019 Category: International Medicine & Public Health Authors: Timothy S. Jost Source Type: blogs

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While other countries may ration because of national budget constraints and supply-side factors, the United States’ lack of access to comprehensive insurance and affordable care represent a de facto form of rationing that leads people to delay getting care or going without it entirely.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 12, 2019 Category: International Medicine & Public Health Authors: Roosa Tikkanen, Robin Osborn Source Type: blogs

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We are losing ground on diabetes in the United States, and we need to know why.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 6, 2019 Category: International Medicine & Public Health Authors: David Blumenthal, M.D., Shanoor Seervai Source Type: blogs

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The ACA gives states the option of creating their own insurance marketplace where people can search for and buy comprehensive health plans. Most states, however, have chosen to use the federal marketplace instead. But that’s starting to change, as more states are considering operating their own marketplaces and platforms.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - June 28, 2019 Category: International Medicine & Public Health Authors: Rachel Schwab, JoAnn Volk Source Type: blogs

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Florida Governor Ron DeSantis just signed legislation that allows the state to import lower-cost prescription drugs. In a show of support, the Trump administration directed Secretary of Health and Human Services (HHS) Alex Azar to help Florida create its program. Colorado and Vermont have also enacted importation laws.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - June 28, 2019 Category: International Medicine & Public Health Authors: Jane Horvath Source Type: blogs

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        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - June 22, 2019 Category: International Medicine & Public Health Authors: Leighton Ku, Erin Brantley Source Type: blogs

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Last fall, voters in three conservative states — Idaho, Nebraska, and Utah — approved ballot initiatives to expand eligibility for Medicaid. But passing Medicaid expansion at the ballot box doesn’t translate into immediately enrolling the newly eligible into coverage. Often the process includes reconciling legislative activity, executive branch priorities, and federal approval of waivers.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - June 21, 2019 Category: International Medicine & Public Health Authors: Akeiisa Coleman, Rachel Nuzum Source Type: blogs

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The goal of universal coverage depends on moderating health care costs, which will require overcoming the unjustified variation and inflationary rise in the prices of care, including drug prices. To gain insight into these challenges — and opportunities — it may be instructive to look at pharmaceutical assessment and pricing in Germany. Germany’s health insurance system shares many characteristics with that of the United States, yet the country has lower drug prices, as well as prices that are more directly linked to clinical benefit.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - June 14, 2019 Category: International Medicine & Public Health Authors: James C. Robinson, Patricia Ex, Dimitra Panteli Source Type: blogs

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A new proposal from the Trump administration would roll back civil rights rules governing federally assisted health programs. Issued by the Obama administration in 2016, these rules implement Section 1557 of the Affordable Care Act, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - June 13, 2019 Category: International Medicine & Public Health Authors: Sara Rosenbaum Source Type: blogs

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The Tennessee legislature recently enacted a law to seek federal approval to fund Medicaid through block grants. The plan would likely have indeterminate consequences for Medicaid beneficiaries. George Washington University’s Sara Rosenbaum delves into the potential impact of Tennessee’s new law.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 31, 2019 Category: International Medicine & Public Health Authors: Sara Rosenbaum Source Type: blogs

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A move towards defining gender as sex at birth could have devastating implications for the health and health care of transgender and gender nonconforming individuals, placing an already vulnerable population at even greater risk. (This post is slightly amended from a post previously published on November 8, 2018.)         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 29, 2019 Category: International Medicine & Public Health Authors: Corinne Lewis, Yaphet Getachew, Mekdes Tsega Source Type: blogs

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In a To the Point blog post, Ann Hwang, M.D., of Community Catalyst points out that new initiatives to align services and payments for Medicare–Medicaid dual eligibles exhibit a range of approaches for increasing participation in integrated care models, but cautions that prior programs have had mixed results.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 24, 2019 Category: International Medicine & Public Health Authors: Ann Hwang Source Type: blogs

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Telehealth, which uses telecommunications to support virtual health care delivery to improve access to and quality of health care, is moving from promise to reality. The benefits are appealing: Patients can interact with their providers remotely, which improves access to care and can help providers manage chronic conditions from afar.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 17, 2019 Category: International Medicine & Public Health Authors: Billy Wynne, Josh LaRosa Source Type: blogs

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High-quality primary care is critically important for health. Unfortunately, for low-income people, it often falls short of meeting needs. Over the past year and a half, the Commonwealth Fund held focus groups with more than 100 low-income patients and 30 primary care physicians (PCPs) serving them. Patients and their doctors identified several barriers that hinder access and ability to provide high-quality primary health care and discussed potential solutions.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 16, 2019 Category: International Medicine & Public Health Authors: Corinne Lewis, Laurie Zephyrin, M.D., Melinda K. Abrams, Shanoor Seervai Source Type: blogs

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The Trump administration has made the formation of association health plans (AHPs) — those offered by business or professional associations to their members — a central focus of its health policy agenda by significantly expanding their reach, but a federal court decision made in March has found the new rules violate federal tax law.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 14, 2019 Category: International Medicine & Public Health Authors: Timothy S. Jost Source Type: blogs

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New Hampshire’s work requirement requires adults in Medicaid’s expansion population to work at least 100 hours per month. Almost all of the costs of Medicaid in New Hampshire, as in all states, for the expansion population are borne by the federal government. In 2019, New Hampshire will pay just 7 percent of the cost of Medicaid for expansion enrollees, rising to 10 percent in 2020 and beyond.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 10, 2019 Category: International Medicine & Public Health Authors: Sherry A. Glied Source Type: blogs

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On March 1, 2019, New Hampshire restricted its Medicaid eligibility expansion to require adults ages 19 to 64 to work at least 100 hours per month. Beginning in June, those who fail to report sufficient working hours for two or more months will be dropped from the Medicaid rolls.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 10, 2019 Category: International Medicine & Public Health Authors: Leighton Ku, Erin Brantley Source Type: blogs

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Once again, the Affordable Care Act (ACA) is under threat, this time in the form of Texas v. Azar, a federal lawsuit challenging its constitutionality. This litigation, now under consideration by the Fifth Circuit Court of Appeals, took an unexpected turn in March when the U.S. Department of Justice (DOJ) sided with the plaintiffs, urging the Court to strike the ACA down in its entirety. On May 1, the administration filed a brief in support of this action. But even before this suit, DOJ had refused to defend key provisions that guarantee coverage of preexisting conditions. If the courts agree with the DOJ, it would invalid...
Source: The Commonwealth Fund: Blog - May 8, 2019 Category: International Medicine & Public Health Authors: Sabrina Corlette, Emily Curran Source Type: blogs

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Congress and the Trump administration have considered a range of actions to lower prescription drug prices, but there is one that’s flown under the radar of most policymakers: binding arbitration. At a recent Capitol Hill briefing held by the National Coalition on Health Care — a group of diverse stakeholders seeking a health system that is “more effective, efficient and responsive” — a panel of experts discussed the potential of this option to help determine prices for selected high-cost drugs covered under Medicare Part D.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 4, 2019 Category: International Medicine & Public Health Authors: John Rother Source Type: blogs

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Under the Trump administration, short-term, limited-duration health plans, formerly limited to a three-month duration, can be held for up to nearly one year and renewed for up to three years. The flaws of short-term plans — no requirement to cover essential health benefits, annual limits, preexisting conditions exclusions, and excessive cost-sharing — have been well-documented. But another problem with these health plans is that they do not offer a network of health providers, which leads to unexpected “balance bills” for the consumer.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 1, 2019 Category: International Medicine & Public Health Authors: Christina L. Goe Source Type: blogs

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High health costs are keeping Americans up at night — nearly half of working-age adults say they could not pay an unexpected $1,000 medical bill within 30 days, according to a 2018 Commonwealth Fund survey. Several estimates suggest one of five inpatient emergency department visits may lead to surprise bills. The problem has captured the interest of lawmakers on both sides of the political aisle because these bills have such an outsized impact on consumers and are widely regarded as unfair. But why do people get surprise bills in the first place and what can policymakers do to address the problem?    ...
Source: The Commonwealth Fund: Blog - April 26, 2019 Category: International Medicine & Public Health Authors: David Blumenthal, M.D., Shanoor Seervai Source Type: blogs

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People who qualify for both Medicare and Medicaid — known as dual-eligible beneficiaries — frequently have complex and costly health care needs. Since 2011, the federal Centers for Medicare and Medicaid Services (CMS) has collaborated with 13 states to integrate benefits for this low-income population through a demonstration called the Financial Alignment Initiative.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - April 26, 2019 Category: International Medicine & Public Health Authors: Laura M. Keohane Source Type: blogs

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A new federal initiative is seeking to reduce children’s out-of-home placements in foster care, residential treatment, and inpatient settings in order to improve health outcomes and reduce Medicaid spending.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - April 23, 2019 Category: International Medicine & Public Health Authors: Jocelyn Guyer, Cindy Mann Source Type: blogs

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President Trump’s health care gyrations reflect a political fact: he and Republicans have to have a health plan to run on in 2020. Faced with resurgent Democrats touting health care issues, other incumbent Republican presidents have come to exactly the same conclusion.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - April 17, 2019 Category: International Medicine & Public Health Authors: David Blumenthal, M.D. Source Type: blogs

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Following three years of steady growth, enrollment on the Affordable Care Act’s (ACA) marketplaces began to dip in 2017. Recently reported numbers show that trend continued into this year, thanks to a number of headwinds.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - April 17, 2019 Category: International Medicine & Public Health Authors: Rachel Schwab, Sabrina Corlette Source Type: blogs

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        (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - April 11, 2019 Category: International Medicine & Public Health Authors: JoAnn Volk, Kevin Lucia Source Type: blogs

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The Trump administration released guidance last week that is good news for people with chronic conditions. Starting in 2020, Medicare Advantage plans — private health plans that contract with Medicare — will be allowed, but not required, to offer chronically ill enrollees nonmedical services for social needs that affect health. This is an important step for Medicare. Many older Americans, particularly those who are very sick, will greatly benefit given their high levels of unmet social needs.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - April 9, 2019 Category: International Medicine & Public Health Authors: Melinda K. Abrams, Shawn Bishop Source Type: blogs