Health Affairs

Last Thursday’s Republican Presidential Debate in Florida included a lively, but not always accurate, exchange on health reform in Massachusetts.  In particular, Senator Santorum reported that one in four Massachusetts residents were going without needed care because of high costs; he also implied that the share of residents choosing to pay the fine for failing [...]

Massachusetts’s health reform bill, which provided the template for the federal Affordable Care Act, went into effect in 2006. In a statewide survey taken in 2010, 94.2 percent of the state’s nonelderly (19–64) residents reported being covered, a significant increase over the 86.6 percent estimate of 2006. The survey is reported in a Health Affairs [...]

On November 8, 2011, the Centers for Medicare & Medicaid Services (CMS) solicited the public for feedback on Medicare’s controversial coverage with evidence development (CED) policy. Although CMS did not finalize the CED policy until 2006, the agency first applied the CED concept in 1995 through a national coverage determination (NCD) on lung volume reduction [...]

As every reader knows, the Supreme Court has agreed to consider challenges that have been brought to the constitutionality of two provisions of the Affordable Care Act (ACA) by twenty-six states, the National Federation of Independent Businesses, and individual plaintiffs.  The Court has scheduled the case for five and a half hours of oral arguments [...]

With primary care medicine facing ever increasing pressures—fewer doctors to treat more patients and a continual maze of restrictions on reimbursement—primary care practitioners are trying to diagnose and treat obesity with one hand tied behind their backs. The result, unfortunately, is that for what is likely the nation’s costliest disease, strains on coverage have been [...]

With apologies to my more creative predecessors as Health Wonk Review hosts, there’s no theme today. (After all, how could one top Alistair Cookie?) I will get right to the great posts in this week’s edition. Costs And Premiums. At Managed Care Matters, Joe Paduda explores an apparent disconnect: flat medical costs coupled with rising [...]

Wednesday, September 28 was a busy day at the Supreme Court clerk’s office. It had been widely expected that there would be a major pleading filed with the clerk in an Affordable Care Act challenge, as the response of the United States to a certiorari petition in the Sixth Circuit’s Thomas More case, which had [...]

Total premiums for employer-sponsored family health coverage have reached $15,073, up 9 percent from last year, the Kaiser Family Foundation and the Health Research and Educational Trust reported yesterday in their annual Employer Health Benefits Survey. This sharp rise comes after a string of comparatively mild increases. Last year, family premiums increased 3 percent, after [...]

Steadily rising health care costs are exacting a heavy financial toll on many families, leaving them with less and less disposable income while increasing the federal deficit, according to a study in the recently released September issue of Health Affairs.  From 1999 to 2009, an average American family of four saw its annual income increase [...]

One of the great advances for people with disabilities under the Patient Protection and Affordable Care Act is its coverage standards for the individual and small group markets.  To be sure, the Act’s best known provisions where disability is concerned are those that bar insurers from totally denying access for people with higher health care [...]

Editor’s Note: For more Health Affairs Blog coverage of the new Census Bureau health insurance data, see Nina Owcharenko’s post. Most of the newspaper coverage of the just-released Census Bureau data on health insurance coverage has focused changes in coverage between 2009 and 2010.  Since the advent of the Great Recession, the reduction in health [...]

Editor’s Note: For more Health Affairs Blog coverage of the new Census Bureau health insurance data, see Henry Aaron’s post. In its yearly survey of health insurance coverage, the U.S. Census Bureau published figures that underscore the trend toward greater dependence on government for coverage. The percentage of Americans on government health programs continues to [...]

One of the most important innovations of the Affordable Care Act (ACA) is that it dramatically increases and improves the information that consumers have available about health insurance and health care.  HHS has already implemented provisions of the ACA requiring insurers to disclose information regarding their medical loss ratios and to publicly justify unreasonable rate [...]

All health care spending in the United States is projected to grow at an annual average rate of 5.8 percent for the period 2010 through 2020, 1.1 percentage points faster than expected growth in Gross Domestic Product (GDP). By 2020, health care spending is projected to be 19.8 percent of GDP, nearly one-fifth of economic [...]

Section 1001 of the Affordable Care Act establishes women’s preventive health benefits as a new mandatory coverage class for all insurance products sold in the individual and group markets, self insured employer-sponsored health plans, and benchmark plans enrolling newly eligible Medicaid beneficiaries.  In implementing the Act in accordance with the tight deadlines established under the [...]

On July 7, 2011, Health Affairs will unveil its July 2011 issue, “New Directions In Systems Innovations.” The issue explores ongoing innovations in health care organization, delivery and financing across a broad front – from Vermont’s recent passage of single payer legislation, to new responsibilities for hospital boards of trustees as a consequence of the [...]

Thomas Saving’s and John Goodman’s post on the implications of the Affordable Care Act for Medicare leads the list of most-read Health Affairs Blog posts for May. On the list as well are posts on the hazards of ignoring the lessons of the Clinton years; the opportunities offered by clinical registries; and the implications of [...]

Editor’s Note: In addition to Alain Enthoven and Leonard Schaeffer (photos and bios above), this post is coauthored by David Helwig and Phil Lebherz. Helwig retired as President and CEO West Region for WellPoint, Inc., and he also served as chief executive officer and president of Blue Cross of California. Lebherz is Chairman of LISI, [...]

On April 28th, the New England Journal of Medicine published the results of a study that compared two drugs head-to-head for the treatment of age-related macular degeneration (AMD), the leading cause of legal blindness in the United States.  The two drugs, Ranibizumab (Lucentis) and Bevacizumab (Avastin), are very similar molecules and are both meant to [...]

Editor’s Note: The authors of the post below, Dan Mendelson and Tanisha Carino, also wrote an earlier post on the initial decision of the Centers for Medicare and Medicaid Services to undertake a national coverage review of the cancer drug Provenge. In one of its most anticipated national coverage decisions (NCD), issued on March 30, [...]