House Hearing on PSLF Implementation

On Thursday the House Education and Labor’s Subcommittee on Higher Education and Workforce Investment Subcommittee will hold a hearing on, “Broken Promises: Examining the Failed Implementation of the Public Service Loan Forgiveness Program”. The hearing, which is scheduled take place at 10:15am, will consist of two witness panels.

Panel I will include the following witnesses: Ms. Kelly Finlaw, Teacher, New York City; Mr. James H. Steeley, President and Chief Executive Officer, Pennsylvania Higher Education Assistance Agency; Ms. Yael Shavit, J.D., Assistant Attorney General, Office of the Massachusetts Attorney General; Mr. Matthew M. Chingos, Ph.D., Vice President for Education Data and Policy, Urban Institute

Panel II will include the following witnesses: Ms. Melissa Emery-Arras, Director, Education, Workforce, and Income Security, Government Accountability Office; Mr. Jeff Appel, Office of Federal Student Aid, Director of Policy Liaison and Implementation, U.S. Department of Education

More information may be accessed here. 

Concentration Of Commercial Health Insurance Markets

According to a study from the American Medical Association based on guidelines used by the Department of Justice and Federal Trade Commission to assess market competition, 75% of U.S. commercial health insurance markets were highly concentrated in 2018, compared to 71% in 2014.   

More information about the study can be obtained at

https://www.ama-assn.org/delivering-care/patient-support-advocacy/competition-health-insurance-research.

A Typology For Analyzing Coverage Gains By State: 2013-2017

A new brief from the Urban Institute explores state variation in health insurance coverage changes during implementation of the primary health insurance coverage reforms of the Affordable Care Act (ACA) using data from the 2013 and 2017 American Community Survey. State variation is summarized using a typology that groups states according to their pre-ACA uninsurance levels, Medicaid expansion status, and efforts to encourage marketplace enrollment.  

The brief can be obtained at https://www.urban.org/sites/default/files/publication/101035/a_typology_for_analyzing_coverage_gains_by_state_2013-2017.pdf.

Health Insurance State Innovation Waivers And Older Adults: A Guide For States

Section 1332 State Innovation Waivers, named after the section of the Affordable Care Act that created them, are intended to allow states to implement innovative strategies to provide health coverage for their residents. This Insight on the Issues from the AARP Public Policy Institute provides a guide for states to understand the landscape and history of these waivers and how they can have an impact. 

The report can be obtained at https://www.aarp.org/content/dam/aarp/ppi/2019/09/health-insurance-state-innovation-waivers-and-older-adults-state-guide.doi.10.26419-2Fppi.00081.003.pdf.

Learning From Health Care Setbacks To Achieve Success

Failure is essential to innovation, but few health care organizations see setbacks as learning opportunities that can help achieve goals of improving health and reducing cost. A Commonwealth Fund report shares lessons from innovators who overcame obstacles to implementing new ways of delivering care.

The report can be obtained at https://www.commonwealthfund.org/sites/default/files/2019-09/Klein_course_corrections_hlt_innovators.pdf.

Health Care Employment Data

Employment at the nation's hospitals increased in August 2019 to a seasonally adjusted 5,253,200 employees, according to a Bureau of Labor Statistics report. That figure is 8,800 more than in July and 97,400 more than a year ago. Overall, the health sector increased in August to a seasonally adjusted 16,436,700 employees, representing an increase of 23,900 more than in July and 367,000 more than one year ago.

The report can be obtained at https://www.bls.gov/news.release/empsit.t17.htm.

Changes In Enrollment In The Individual Health Insurance Market Through Early 2019

Following the implementation of the ACA, the individual health insurance market grew rapidly. A new analysis measures changes in enrollment in the individual market before and after the ACA’s coverage expansions and market rules went into effect in 2014 through the first quarter of 2019.

The analysis can be obtained at https://www.kff.org/private-insurance/issue-brief/data-note-changes-in-enrollment-in-the-individual-health-insurance-market-through-early-2019/.

Hospital Mergers Enhance Patient Quality And Cost Reduction

Hospital Merger Benefits: Views from Hospital Leaders and Econometric Analysis – An Update, is a report from Charles River Associates that updates a 2017 report. The latest findings both reinforce and strengthen the previous report’s conclusions that hospital mergers can generate significant value for patients and their communities in the form of better care and reduced costs.

 The report can be obtained at https://www.aha.org/2019-09-04-charles-river-associates-report-hospital-merger-benefits.

Role Of Three Federal Departments In Influencing Health

While the U.S. Department of Health and Human Services has a substantial responsibility in advancing the health of the nation, other federal departments and agencies also can have a significant impact on disease prevention and health promotion. Health in All Policies (HiAP) is a strategy that considers the factors that influence health across all levels of policymaking to improve health outcomes. A report from the Bipartisan Policy Center explores how the U.S. Department of Education (ED), U.S. Department of Treasury (Treasury), and U.S. Department of Labor (DOL) currently implement a HiAP approach and how these departments can build on these efforts. 

The report can be obtained at https://bipartisanpolicy.org/wp-content/uploads/2019/08/Health-in-All-Policies.pdf.

Confidence In Higher Education Declining

As students return to campus, the Pew Research Center reports that new survey results show that only half of Americans think colleges and universities are having a positive effect on the way things are going in the U.S. these days, and 61% indicate that the higher education system is moving in the wrong direction. 

The report can be obtained at https://www.pewsocialtrends.org/essay/the-growing-partisan-divide-in-views-of-higher-education/?utm_campaign=2019-08-28+Rundown&utm_medium=email&utm_source=Pew.

International Perspective On The Paradoxes Of U.S. Health Care

Premium Contributions And Cost-Sharing For Families With Large Employer Coverage

According to a brief from the Peterson-Kaiser Health System Tracker, as health costs rise, enrollees in large employer plans face higher health spending both through rising premium contributions and increased cost-sharing when they use services. On average, health spending by families with large employer health plans has increased two times faster than workers’ wages over the last decade. This increase has been driven in part by rising deductibles. 

The brief can be obtained at https://www.healthsystemtracker.org/brief/tracking-the-rise-in-premium-contributions-and-cost-sharing-for-families-with-large-employer-coverage/.

ACA’s Individual Health Insurance Market’s Resemblance To The Group Market

A posting from the Commonwealth Fund discusses the alignment between the Affordable Care Act’s individual market and the small- and large-group markets.  

The posting can be obtained at https://www.commonwealthfund.org/blog/2019/individual-health-insurance-market-looking-more-group-market-under-affordable-care-act.

CMS To Require Five-Star Quality Rating System For Plans On Health Insurance Exchanges

For the first time, the Centers for Medicare & Medicaid Services (CMS) will require the display of the five-star Quality Rating System available nationwide for health plans offered on the Health Insurance Exchanges beginning with the 2020 Open Enrollment Period November 1, 2019 to December 15, 2019. Star ratings are based on a number of important factors, including how other enrollees rate physicians in the plan’s network and the care they receive, how well the plan’s network providers coordinate with enrollees and other physicians to give members healthcare that achieves the best results, and overall administration of the plan including customer service and availability of information. 

Additional information can be obtained at https://www.cms.gov/newsroom/fact-sheets/health-insurance-exchange-quality-ratings-system-101.

Final “Public Charge” Rule Involving Immigration

Earlier this week, the Trump administration revealed its long-anticipated final “public charge” rule, a policy change that effectively would punish legal immigrants who use their Medicaid coverage to help pay for nonemergency medical care. A posting on the website of the Commonwealth Fund comments on the rule. 

The posting can be obtained at https://www.commonwealthfund.org/blog/2019/new-public-charge-rule-affecting-immigrants-has-major-implications-medicaid-and-entire?redirect_source=/blog/2018/new-public-charge-rule-affecting-immigrants-has-major-implications-medicaid.