{"id":7589,"date":"2023-11-13T09:00:33","date_gmt":"2023-11-13T14:00:33","guid":{"rendered":"https:\/\/chirblog.org\/?p=7589"},"modified":"2023-11-13T09:02:47","modified_gmt":"2023-11-13T14:02:47","slug":"october-research-roundup-what-were-reading","status":"publish","type":"post","link":"https:\/\/chirblog.org\/october-research-roundup-what-were-reading\/","title":{"rendered":"October Research Roundup: What We’re Reading"},"content":{"rendered":"\n
In preparation for Health Policy Halloween<\/a>, CHIR read up on the latest health policy research. In October, we read studies on consumer experiences enrolling in the Affordable Care Act (ACA) Marketplace, health care affordability issues among the insured and uninsured, and the impact of Medicaid expansion on coverage in heavily redlined areas.<\/p>\n\n\n\n Kaye Pestaina, Cynthia Cox, and Rayna Wallace, Signing Up for Marketplace Coverage Remains a Challenge for Many Consumers<\/a>, KFF, October 30, 2023. Authors analyzed results from KFF\u2019s 2023 Survey of Consumer Experience with Health Insurance<\/a>, a nationally representative survey of 3,065 adults that included 880 Marketplace enrollees (both HealthCare.gov and state-based Marketplace (SBM) enrollees).<\/p>\n\n\n\n What it Finds<\/em><\/p>\n\n\n\n Why it Matters<\/em><\/p>\n\n\n\n More people than ever<\/a> rely on the ACA Marketplaces for health insurance. When shopping for coverage, individuals and families often have to make complex comparisons of provider networks, benefits, deductibles, premiums, and cost-sharing amounts, and a significant increase<\/a> in the number of plan options contributes<\/a> to suboptimal plan selections. The administrative burden of the enrollment process itself may also deter<\/a> consumers from signing up for coverage. Marketplaces have pursued a number of policy interventions to improve the shopping and enrollment experience, such as standardizing<\/a> plan design, simplifying<\/a> the sign-up process, and investing<\/a> in enrollment assistance. Still, this KFF survey and analysis identifies ongoing pain points for consumers. As stakeholders consider ways to improve the Marketplaces as a source of coverage, these findings can help guide efforts to help consumers access plans that meet their health and financial needs. <\/p>\n\n\n\n Sara R. Collins, Shreya Roy, and Relebohile Masitha, Paying for It: How Health Care Costs and Medical Debt Are Making Americans Sicker and Poorer: Findings from the Commonwealth Fund 2023 Health Care Affordability Survey<\/a>, Commonwealth Fund, October 26, 2023. This analysis of the Commonwealth Fund\u2019s inaugural survey on health care affordability examines challenges affording health care, medical debt, and health outcomes among a nationally representative sample of 6,121 working-age U.S. adults (ages 19\u201364) with and without health insurance.<\/p>\n\n\n\n What it Finds<\/em><\/p>\n\n\n\n Why it Matters<\/em><\/p>\n\n\n\n The Commonwealth Fund\u2019s new survey shows the continued disparities in affordability and access between the insured and uninsured and adds to the growing body of evidence that even insured patients are not immune to the consequences of rising provider prices<\/a>. Respondents with private insurance reported affordability challenges, delayed and foregone care, worsening health outcomes, and struggles with medical debt. The study authors propose a number of promising policy reforms to improve affordability, such as regulating<\/a> aggressive medical debt collection and using public option plans<\/a> to help slow cost increases in the commercial market. Although reforms like the ACA<\/a>, No Surprises Act<\/a>, and Inflation Reduction Act<\/a> have made great strides in protecting consumers from the high cost of health care, broader cost containment measures are needed to combat the growing health care affordability crisis.<\/p>\n\n\n\n Joseph Semprini, Abdinasir K. Ali, and Gabriel A. Benavidez, Medicaid Expansion Lowered Uninsurance Rates Among Nonelderly Adults in the Most Heavily Redlined Areas<\/a>, Health Affairs, October 2023. Researchers analyzed uninsurance rates before and after the ACA\u2019s Medicaid expansion by race and exposure to historical \u201credlining,\u201d a now-outlawed form of structural racism<\/a> where neighborhoods were appraised based on their racial composition; neighborhoods consisting of upper-class White residents were deemed \u201cdesirable,\u201d and neighborhoods primarily consisting of racial and ethnic minorities were seen as \u201chazardous,\u201d contributing to wealth and home ownership disparities that persist today. Using American Community Survey<\/a> (ACS) data coupled with corresponding redlining data derived from the Mapping Inequality<\/a> project, researchers grouped census tracts into four categories, ranging from the least exposure to redlining (category 1) to the most exposure to redlining (category 4), and compared uninsurance rates before (2009\u20132013) and after (2015\u20132019) Medicaid expansion in those census tracts. <\/p>\n\n\n\n What it Finds<\/em><\/p>\n\n\n\n Why it Matters<\/em> <\/p>\n\n\n\n This study demonstrates how structural racism\u2014even policies that are no longer in effect\u2014influences access to health coverage. The impacts of redlining are still being felt decades after the Fair Housing Act outlawed the practice; before Medicaid expansion, uninsurance rates were highest in census tracts suffering the greatest amount of redlining. Medicaid expansion reduced uninsurance rates in communities where redlining occurred, demonstrating the importance of proactive policy interventions to narrow the disparities stemming from systemic segregation. By choosing not to expand Medicaid<\/a>, ten states have left low-income residents living in historically redlined areas without sufficient access to coverage. Future policymaking should confront the continuing impact of structural racism on health and coverage disparities, and stakeholders working towards health equity, whether through Medicaid expansion or other policy<\/a> interventions<\/a>, can benefit from the contextual framework employed by this study. <\/p>\n","protected":false},"excerpt":{"rendered":" In preparation for Health Policy Halloween, CHIR read up on the latest health policy research. In October, we read studies on consumer experiences enrolling in the Affordable Care Act (ACA) Marketplace, health care affordability issues among the insured and uninsured, and the impact of Medicaid expansion on coverage in heavily redlined areas.<\/p>\n","protected":false},"author":36,"featured_media":7176,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[217,13,574,815,248],"_links":{"self":[{"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/posts\/7589"}],"collection":[{"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/users\/36"}],"replies":[{"embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/comments?post=7589"}],"version-history":[{"count":3,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/posts\/7589\/revisions"}],"predecessor-version":[{"id":7592,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/posts\/7589\/revisions\/7592"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/media\/7176"}],"wp:attachment":[{"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/media?parent=7589"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/categories?post=7589"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/chirblog.org\/wp-json\/wp\/v2\/tags?post=7589"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n
\n
\n
\n
\n
\n
\n